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Sample records for vertebral artery origin

  1. PICTORIAL ESSAY Is anomalous origin of the left vertebral artery ...

    African Journals Online (AJOL)

    The incidence of anomalous origin of the left vertebral artery from the aortic arch ranges between 1% and 5.8%.1,2 This anomaly has important implications for thoracic surgery and interventional procedures. The left vertebral artery may originate from: • the left common carotid artery. • the root of the left subclavian artery ...

  2. ORIGINAL ARTICLE The pattern and prevalence of vertebral artery ...

    African Journals Online (AJOL)

    ORIGINAL ARTICLE. 52 SAJR June 2013 Vol. 17 No. 2. Vertebral artery injuries are rare, with an incidence of 0.1 - 1.0%, if all patients admitted with blunt head trauma are considered.[1] It is not unusual for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth ...

  3. PICTORIAL ESSAY Is anomalous origin of the left vertebral artery ...

    African Journals Online (AJOL)

    Department of Diagnostic Radiology, 2 Military Hospital, Wynberg, Cape Town. Sulaiman Moosa, MB ChB, MPhil, BSc Hons, FFRad Diag (SA). Corresponding author: B van der Merwe (attiemalan@mweb.co.za). We present a pictorial review of anomalous origin of the left vertebral artery observed in 5 patients imaged in ...

  4. Aberrant right vertebral artery originating from the aortic arch distal to the left subclavian artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Soo Heui; Baek, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-03-15

    We present a rare case of an aberrant right vertebral artery originated from the distal aortic arch. This issue has been incidentally detected on a preoperative CT angiography after a stabbing injury of the cervical spinal cord. Normally, the right vertebral artery originates from the right subclavian artery. Therefore, in this case report we will review the incidence and the embryological mechanism of this aberrant course of the right vertebral artery and we will discuss as well the clinical importance of this variation.

  5. Is anomalous origin of the left vertebral artery indeed a rare finding ...

    African Journals Online (AJOL)

    We present a pictorial review of anomalous origin of the left vertebral artery observed in 5 patients imaged in our after-hours trauma radiology unit within a period of 7 days. We raise the question of whether the incidence of anomalous origin of the left vertebral artery quoted in the radiology literature as 5% is really that low, ...

  6. Rare variation in the origin of the right vertebral artery

    African Journals Online (AJOL)

    Enrique

    Introduction. Anomalous origin of the right ver- tebral artery from the distal part of the aortic arch is very rare and is discov- ered as an incidental finding during an angiographic study or in laborato- ry specimens. It has been suggested that these anomalies are of diagnostic importance and may be associated.

  7. ANOMALOUS ORIGIN OF THE LEFT VERTEBRAL ARTERY. Origen anómalo de la arteria vertebral izquierda

    Directory of Open Access Journals (Sweden)

    Divya Premchandran

    2016-03-01

    Full Text Available Las variaciones de los principales vasos arteriales son de importancia clínica. La arteria vertebral (VA normalmente surge de la arteria subclavia. El presente informe describe un origen anómalo de la arteria vertebral izquierda (LVA desde el arco aórtico entre el origen de la subclavia izquierda y la arteria carótida común izquierda. Esta arteria cruzó superficialmente de medial a lateral el tronco simpático izquierdo. La VA izquierda y derecha entraban en los agujeros transversos de la quinta vértebra cervical. Aunque el origen anómalo de la VA es bien conocida, su origen y la entrada a través del foramen transversal y sus relaciones con tronco simpático son de importancia clínica y durante los procedimientos vasculares en la región de cabeza y cuello tales como los stent de arteria carótida o vertebral y las intervenciones intracraneales. Variations of major arterial vessels are of clinical significance. The vertebral artery (VA normally arises from the subclavian artery. The present report describes an anomalous origin of the left vertebral artery (LVA from the aortic arch between the origin of the left subclavian and the left common carotid arteries. This artery was crossed superficially from medial to lateral by the left sympathetic trunk. The left and right VA entered the foramen on the transverse process of the fifth cervical vertebra. Though the anomalous origin of the VA is known, its origin and entry through the transverse foramen and its relations with sympathetic trunk are of importance during clinical and vascular procedures in the head and neck region like carotid artery stents, VA stents and intracranial interventions.

  8. Dual origin of the left vertebral artery: extracranial MRA and CTA findings.

    LENUS (Irish Health Repository)

    Tobin, W Oliver

    2012-02-01

    A 48-year-old man presented with a posterior circulation stroke secondary to left lateral medullary infarction. Contrast-enhanced magnetic resonance angiography (CEMRA) revealed 40-45% intracranial left vertebral artery stenosis, likely atherosclerotic in nature. CEMRA and subsequent computed tomography angiography also identified a duplicate origin of the left vertebral artery. The importance of recognition of this rare anatomical variant, its potential contribution to stroke aetiology, and the advantage of non-invasive vascular imaging prior to catheter angiography is emphasised.

  9. Risk factors for in-stent restenosis of vertebral artery origin after stent implantation: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    Fang-fang HAO

    2018-01-01

    Full Text Available Objective To systematically review the risk factors for in-stent restenosis (ISR of vertebral artery origin after sent implantation to provide theoretical foundation for clinical prevention and treatment. Methods Taking vertebral artery, vertebrobasilar insufficiency, stents, drug-eluting stents, self expandable metallic stents in English and Chinese as key words, retrospective clinical studies about risk factors for ISR of vertebral artery origin were searched by using PubMed, EMBASE/SCOPUS, Cochrane Library, China Biology Medicine (CBM, China National Knowledge Infrastructure (CNKI, Wanfang Data and VIP database from January 1, 1966 to March 30, 2017. Quality assessment and Meta-analysis were made by using Newcastle-Ottawa Scale (NOS and Stata 12.0 software. Results The research enrolled 3468 articles in all, from which 11 studies were chosen after excluding duplicates and those not meeting the inclusion criteria. A total number of 1352 patients were divided into ISR group (N = 440 and non-ISR group (N = 912. The ISR incidence rate of smokers was significantly higher than non-smokers (OR = 2.179, 95%CI: 1.373-3.458; P = 0.001. The differences of bare metal stents (BMS utilization rate (OR = 2.072, 95% CI: 1.560-2.753; P = 0.000 and drug-eluting stents (DES utilization rate (OR = 0.483, 95% CI: 0.363-0.641; P = 0.000 between ISR group and non-ISR group were statistically significant. Conclusions Smoking and using BMS are risk factors for ISR of vertebral artery origin, and using DES is protective factor. Due to limited study quality, more high-quality studies are needed to verify this conclusion. DOI: 10.3969/j.issn.1672-6731.2017.12.004

  10. A case of anomalous origin and course of vertebral artery in a patient with klippel feil syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ulusoy, Onur Levent; Barlas, Sezgi Burcin; Mutlu, Ayhan [Dept. of Radiology, Istanbul Florence Nightingale Hospital, Istanbul (Turkmenistan); Sasani, Hadi [Dept. of Radiology, Near East University School of Medicine, Nicosia (Cyprus); Sasani, Mehdi [Dept. of Anatomy, Trakya University, Faculty of Medicine, Edirne (Turkmenistan)

    2016-07-15

    Patients with Klippel-Feil syndrome (KFS) have an increased incidence of vascular anomalies as well as vertebral artery (VA) anomalies. In this article, we presented imaging findings of a 15-year-old female patient with KFS with a rare association of extraforaminal cranially ascending right VA that originated from the ipsilateral carotid bulb. Trifurcation of the carotid bulb with VA is a very unusual variation and to the best of our knowledge, right-sided one has not been reported in the literature.

  11. The right vertebral artery originating from the right occipital artery and the absence of the transverse foramen: a rare anatomical variation.

    Science.gov (United States)

    Öner, Zülal; Öner, Serkan; Kahraman, Ayşegül Sağır

    2017-12-01

    Variations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin. In this case, we aimed to present the right VA originating from the right occipital artery and concomitant anomalies of the transverse foramen that have not been reported previously according to our knowledge in literature. In a 32-year-old female patient referred to our hospital because of dizziness, the right VA was not observed on magnetic resonance imaging and computed tomography angiography (CTA) examination was performed. CTA showed hypoplasia of the right transverse foramen at the levels of the C1, C5 and C6 vertebrae and aplasia of the right transverse foramen at the levels of the C2, C3 and C4 vertebrae. The right VA originating from the right occipital artery continues to its normal course by entering the cranium through the foramen magnum at the level of the atlantooccipital junction.

  12. Vertebral artery dissection associated with sildenafil abuse.

    Science.gov (United States)

    Dersch, Rick; Anastasopoulos, Constantin; Hader, Claudia; Stich, Oliver

    2013-05-01

    We present a 49-year-old male who suffered a cerebellar infarction due to a vertebral artery dissection. The patient had taken sildenafil daily for at least 2 years for sexual enhancement. There was no sexual intercourse or traumatic event prior to symptom onset. Sildenafil intake has been associated with aortic dissection and, in the light of this report, we suggest that chronic sildenafil intake could be a risk factor for arterial dissection. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. "Ostrich sign" indicates bilateral vertebral artery dissection.

    Science.gov (United States)

    Rose, David Z; Husain, M Rizwan

    2012-11-01

    Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign." Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. ANOMALOUS PREVERTEBRAL COURSE OF THE LEFT VERTEBRAL ARTERY. Recorrido prevertebral anómalo de la arteria vertebral izquierda

    Directory of Open Access Journals (Sweden)

    Prakash B Billakanti

    2016-03-01

    Full Text Available La arteria vertebral es una de las arterias que irriga el cerebro. El conocimiento de la anatomía normal y las variantes de la arteria vertebral adquiere importancia en la práctica clínica y la radiología vascular. El origen anómalo de la arteria vertebral del arco de la aorta o cualquiera de las arterias del cuello ha sido reportado por muchos autores. En este informe se presenta una variación del curso prevertebral de la arteria vertebral izquierda. La arteria vertebral tenía su origen habitual en la arteria subclavia con un largo curso prevertebral y entraba en el foramen transversarium de la vértebra CII. El origen y recorrido de la arteria vertebral en el lado derecho fue normal. Clínicamente es importante conocer el origen y curso del segmento prevertebral de la arteria vertebral y las posibles variaciones. El presente informe debería ser de interés para el médico vascular con respecto a las variaciones en el cuello y región torácica, y puede dar idea para dilucidar el mecanismo de desarrollo de la angiogénesis. Vertebral artery is one of the arteries supplying the brain. Knowledge of the normal and variant anatomy of the vertebral artery assumes importance in clinical practice and vascular radiology. Anomalous origins of the vertebral artery from the arch of the aorta or any one of the arteries of the neck have been reported by several authors. In this report a variation of the prevertebral course of the left vertebral artery is being presented. The Vertebral artery had usual origin from the subclavian artery and had a longer prevertebral course to enter the foramen transversarium of the CII vertebra. The origin and course of the vertebral artery on the right side was normal. It is clinically important to know the origin and course of the prevertebral segment of the vertebral artery and possible variations. The present report should be of interest for clinicians with regard to vascular variations in the neck and thoracic

  15. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    OpenAIRE

    D. M. Galaktionov; A. V. Dubovoy; K. S. Ovsyannikov

    2017-01-01

    This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship....

  16. Ischemic stroke: carotid and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P.; Goulao, A. [Hospital Garcia de Orta, Servico de Neurorradiologia, Almada (Portugal)

    2005-03-01

    Ischemic strokes may have distinct aetiologies, including several different intrinsic arterial pathological disorders. The diagnosis and understanding of these arterial diseases is critical for the correct management of stroke as different treatment approaches are undertaken according to the aetiology. Atherosclerosis is by far the most common arterial disease among adults, and other pathological processes include arterial dissection, small vessel disease, inflammatory and non-inflammatory vasculopathy and vasomotor disorders. In children, there are several vasculopathies responsible for vaso-occlusive disease such as sickle-cell anemia, acute regressive angiopathy and Moya-Moya disease, neurofibromatosis, dissections, vasculitis associated with intracranial and systemic infections. An overview of the major carotid and vertebral pathological diseases responsible for ischemic stroke in adults and children, highlighting the accuracy of the different imaging modalities for its diagnosis and the imaging appearance of these diseases, is given. (orig.)

  17. Factors for vertebral artery injury accompanied by cervical trauma

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide [San-in Rosai Hospital, Yonago, Tottori (Japan). Spine and Low Back Pain Center

    2001-09-01

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  18. The origin of the vertebrate skeleton

    Science.gov (United States)

    Pivar, Stuart

    2011-01-01

    The anatomy of the human and other vertebrates has been well described since the days of Leonardo da Vinci and Vesalius. The causative origin of the configuration of the bones and of their shapes and forms has been addressed over the ensuing centuries by such outstanding investigators as Goethe, Von Baer, Gegenbauer, Wilhelm His and D'Arcy Thompson, who sought to apply mechanical principles to morphogenesis. However, no coherent causative model of morphogenesis has ever been presented. This paper presents a causative model for the origin of the vertebrate skeleton, based on the premise that the body is a mosaic enlargement of self-organized patterns engrained in the membrane of the egg cell. Drawings illustrate the proposed hypothetical origin of membrane patterning and the changes in the hydrostatic equilibrium of the cytoplasm that cause topographical deformations resulting in the vertebrate body form.

  19. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    Directory of Open Access Journals (Sweden)

    D. M. Galaktionov

    2017-11-01

    Full Text Available This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest. 

  20. Giant pseudoaneurysm of the extracranial vertebral artery: case report

    OpenAIRE

    Pasquale Gallo; Amauri Dalacorte; Eduardo Raupp; Santos,Amir J.; Frank,Marcos R. C.; Glauco A. Saraiva

    1996-01-01

    Pseudoaneurysms of the extracranial vertebral artery are extremely rare due to their deep location and the anatomical protection of this artery. They can be caused by cervical traumas (firearm injuries, sports, hyperextension of the neck and iatrogeny). The authors report the case of a patient who developed a giant pseudoaneurysm of the extracranial vertebral artery after surgery for the removal of a tumor of the cerebellopontine angle in which surgical lesion of the artery occurred. Treatmen...

  1. Vertebral Artery Dissecting Aneurysm Treated by Proximal Occlusion and Posterior Inferior Cerebellar Artery Reconstruction With Fenestrated Clips

    OpenAIRE

    Li, Yuhui; HORIUCHI, Tetsuyoshi; Nakagawa, Fukuo; Hongo, Kazuhiro

    2010-01-01

    A 57-year-old man presented with subarachnoid hemorrhage caused by a dissecting aneurysm of the vertebral artery close to the origin of the posterior inferior cerebellar artery (PICA). The aneurysm was treated successfully with two fenestrated clips preserving the efferent artery with anterograde blood flow without PICA anastomosis. The postoperative course was uneventful. Postoperative angiography indicated disappearance of the aneurysm and anterograde blood flow of the PICA.

  2. Clinical and radiological evaluation in vertebral artery dissections

    Directory of Open Access Journals (Sweden)

    Murat Çabalar

    2013-04-01

    Full Text Available In recent years, vertebral artery dissection (VAD is reported more frequently as a cause of young cerebrovascular accidents. It can occur spontaneously or following a neck manipulation and trauma. The patients were 3 females (mean age: 35±26 years and 7 males (mean age: 37.71±4.96 years. Only 2 patients described neck trauma. Cerebellar findings were prominent in all cases. On radiological investigation, vascular changes of vertebral arteries were detected bilaterally in 2 cases, right in 5 and left in 3 cases. All the cases were treated with anticoagulant therapy and cured but 1 with sequela. Prognosis of vertebral artery dissection is generally good by early diagnosis and treatment. In this article, we reported clinical and radiological properties of 10 vertebral artery dissection cases.

  3. MR manifestations of vertebral artery injuries in cervical spine trauma

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Jeong Sik; Chung, Tae Sub; Kim, Young Soo; Cho, Yong Eun; Kang, Byung Chul; Kim, Dong Ik [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To assess the diagnostic efficacy of magnetic resonance (MR) imaging in the detection of a vertebral artery injury occurring from major cervical spine trauma. Conventional MR findings of 63 patients and 63 control subjects were compared to detect a possible change in the vertebral arteries resulted from trauma. Plain films, CT and clinical records were also reviewed to correlate the degree of cervical spine injury with vascular change. Nine cases of absent flow signals in vessel lumen were observed in eight patients and one was observed in the control group. Patients more frequently demonstrated other abnormalities such as intraluminal linear signals (n=3) or focal luminal narrowing (n=9) but there was no statistical significance. There was a close relationship between degree of cord damage and occlusion of the vertebral artery. Conventional MR imaging is useful in the detection of vertebral artery occlusion resulting from cervical spine trauma.

  4. An interesting case report of vertebral artery dissection following polytrauma

    Directory of Open Access Journals (Sweden)

    Vikas Acharya

    2016-01-01

    Conclusion: Our report displays select images related to this case report and emphasizes the consideration of routine imaging in head and neck traumatic injuries to diagnose internal carotid and/or vertebral artery dissections much earlier.

  5. Closed cervical spine trauma associated with bilateral vertebral artery injuries

    NARCIS (Netherlands)

    Kloen, P.; Patterson, J. D.; Wintman, B. I.; Ozuna, R. M.; Brick, G. W.

    1999-01-01

    Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature

  6. Closed cervical spine trauma associated with bilateral vertebral artery injuries.

    Science.gov (United States)

    Kloen, P; Patterson, J D; Wintman, B I; Ozuna, R M; Brick, G W

    1999-01-01

    Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature is reviewed.

  7. Spontaneous Bilateral Vertebral Artery Dissection During a Basketball Game

    Science.gov (United States)

    Mas Rodriguez, Manuel F.; Berrios, Rafael Arias; Ramos, Edwardo

    2016-01-01

    Spontaneous vertebral artery dissection accounts for 2% of all ischemic strokes and can occur as a consequence of sports events. We present an unusual case of spontaneous bilateral vertebral artery dissection in a 30-year-old male patient during a basketball game. He developed severe dysphagia, right hemiparesis, and balance dysfunction. We also present a review of the pathology, diagnosis, symptomatology, treatment, prognosis, and occurrence of this entity in sports. PMID:26733592

  8. Minimal invasive management of traumatic transection of the vertebral artery

    NARCIS (Netherlands)

    de Castro, Steve Mm; Christiaans, Sarah C.; van den Berg, Rene; Schep, Niels Wl

    2014-01-01

    Stab wounds to the neck can be potentially lethal. They are often associated with vascular injury of the carotid artery and jugular vein. Injury of the vertebral artery is rarely seen. The injury can vary from severe bleeding after transection with hemorrhage into the surrounding soft tissues of the

  9. [Hemifacial spasm due to a compression of the facial nerve by a fusiform aneurysm of the vertebral artery: case report].

    Science.gov (United States)

    Tsuchiya, D; Kayama, T; Saito, S; Sato, S

    2000-06-01

    We report a rare case of symptomatic hemifacial spasm caused by a fusiform vertebral artery aneurysm and by a branch of the anterior inferior cerebellar artery compressing the facial nerve at the root exit zone (REZ). A 71-year-old female had an 11-year history of right hemifacial spasm. MRIs demonstrated an aneurysm compressing the facial nerve at the REZ. Angiography disclosed a fusiform aneurysm of the right vertebral artery at the origin of the posterior inferior cerebellar artery. After the vertebral aneurysm was clipped distal to the origin of the posterior inferior cerebellar artery, a branch of the right anterior inferior cerebellar artery was also observed compressing the facial nerve at the REZ. Both the clipped aneurysm and the branch of the anterior inferior cerebellar artery were mobilized away from the REZ of the facial nerve, and a prosthesis was inserted between the branch of the anterior inferior cerebellar artery and the brain stem to keep the aneurysm away from its original position. The patient's hemifacial spasm immediately disappeared without any neurological deficits just after the surgery. Hemifacial spasm, especially caused by an aneurysm, is quite rare. In a review of the literature, we found only 4 cases of symptomatic hemifacial spasm caused by an aneurysm of the vertebral artery. This case is the first reported case of hemifacial spasm caused by both a fusiform vertebral artery aneurysm and a branch of the anterior inferior cerebellar artery compressing the facial nerve at the REZ.

  10. Individualized management for intracranial vertebral artery dissecting aneurysms

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    SHANG Yan-guo

    2012-02-01

    Full Text Available Objective To discuss the individualized management strategy for intracranial vertebral artery dissecting aneurysms. Methods Eighteen patients with intracranial vertebral artery dissecting aneurysms were treated with different surgical methods. Results Eighteen patients underwent different surgical treatment. Five patients underwent complete occlusion of the aneurysm and parent artery by coiling, 5 were treated by stent -assisted coiling (3 densely packed coiling and 2 non-densely packed coiling, 4 underwent stent-only therapy and 3 of them presented hemodynamic improvement after surgery, 3 were treated by direct surgical clipping, and 1 underwent occipital artery-posterior inferior cerebellar artery bypass. Two aneurysms ruptured immaturely, in which one patient died on the third day after operation and one patient occurred moderate disablity. Only 1 patient who underwent complete occlusion of aneurysm and parent artery presented temporarily ischemic symptoms. No adverse effects were seen in other patients. Seventeen patients were followed up for 1 month to 3 years, and all the aneurysms were stable. Conclusion There are many kinds of therapeutic methods for intracranial vertebral artery dissecting aneurysms. The patients should be treated according to several factors such as the clinical manifestations, aneurysm configuration, and relationship with the posterior inferior cerebellar artery. The treatment should be individualized.

  11. Anatomia do sulco da artéria vertebral Vertebral artery groove anatomy

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    Max Franco de Carvalho

    2009-01-01

    Full Text Available INTRODUÇÃO: Diversas técnicas cirúrgicas têm sido realizadas na região craniocervical devido a diversas patologias. Durante o acesso cirúrgico a essa região existe um risco potencial de lesão iatrogênica da artéria vertebral, relacionado ao acesso lateral amplo e à avaliação inadequada da anatomia local. Variações no trajeto da artéria vertebral ocasionam maior risco de lesão vascular. O estudo pré-operatório por imagem da anatomia da artéria vertebral e do seu sulco tem sido realizado para aumentar a segurança cirúrgica. OBJETIVO: Estudar a morfometria da artéria vertebral no atlas através da tomografia computadorizada do sulco da artéria vertebral (SAV em 30 atlas isolados de cadáveres. MATERIAIS E MÉTODOS: O SAV e suas relações com a linha média foram avaliados através de oito medidas lineares e duas angulares, bilateralmente. A média, valor máximo e mínimo, e desvio padrão foram calculados para cada parâmetro. RESULTADOS: O SAV apresentou uma maior largura e maior espessura do lado esquerdo (pINTRODUCTION: Several surgical techniques have been carried through in the skull-cervical region due to various pathologies. During the surgical access to this region, a potential risk of iatrogenic injury of the vertebral artery exists, related to extended lateral access and the inadequate evaluation of the local anatomy. Variations in the groove of the vertebral artery lead to a greater risk of vascular injury during surgery. Preoperative image study of the vertebral artery anatomy and its groove has been realized to enhance surgical safety. OBJECTIVE: to study the morphometry of atlas vertebral artery on computed tomography scan images of the vertebral artery groove (VAG in 30 dry atlas. METHODS: VAG and its relationship with the midline were evaluated through eight linear and two angular measures, bilaterally. The average, maximum and minimum values, and standard deviation were calculated for each parameter

  12. An Unusual Cause of Vertebral Artery Dissection: Esophagogastroduodenoscopy

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    Fernando D. Testai

    2010-01-01

    Full Text Available Brain-supplying arterial dissection is considered one of the most common vascular causes of stroke in younger patients. Dissections are usually preceded by trauma or mechanical stress; the vascular stressor may be trivial as this condition has been described in association with manipulation and stretching the neck. Here we describe a case of vertebral artery dissection and stroke following esophagogastroduodenoscopy. This case highlights a potentially serious complication that may occur after procedures that require hyperextension of the neck.

  13. MRI and MR angiography of vertebral artery dissection

    Energy Technology Data Exchange (ETDEWEB)

    Mascalchi, M. [Cattedra di Radiologia, Universita di Pisa (Italy); Bianchi, M.C. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Mangiafico, S. [Servizio di Neuroradiologia, Ospedale di Careggi, Firenze (Italy); Ferrito, G. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Puglioli, M. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Marin, E. [Servizio di Radiologia, Ospedale S. M. Nuova, Firenze (Italy); Mugnai, S. [Clinica Neurologica, Universita di Firenze (Italy); Canapicchi, R. [Servizio di Neuroradiologia, Ospedale S. Chiara, Pisa (Italy); Quilici, N. [Servizio di Neuroradiologia, Ospedali Riuniti, Livorno (Italy); Inzitari, D. [Clinica Neurologica, Universita di Firenze (Italy)

    1997-05-01

    A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3-20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients. (orig.). With 7 figs., 3 tabs.

  14. [Flow diversion by double-overlapping-stent for fusiform vertebral artery aneurysm: a case report].

    Science.gov (United States)

    Uchino, Haruto; Asano, Takeshi; Nakayama, Naoki; Kuroda, Satoshi; Houkin, Kiyohiro

    2011-01-01

    The authors present the case of a 61-year-old male with a de novo fusiform vertebral artery aneurysm, probably due to non-traumatic dissection. He underwent flow diversion therapy, using a double overlapping technique, because the origin of the contralateral vertebral artery was stenotic. Placement of two stents resulted in marked reduction of blood flow in the aneurysm. Postoperative course was uneventful. Follow-up 3D-CT angiography revealed a patent blood flow in the stent and a gradual progression of intra-aneurysmal thrombosis. Flow diversion therapy can potentially obliterate the complicated cerebral aneurysm with the preservation of blood flow in the parent artery, and would be one of the important therapeutic options in patients with complicated aneurysms in which conventional strategies such as neck clipping, endovascular coiling and parent artery occlusion are not feasible or contraindicated.

  15. Vertebral Artery Dissection Causing Stroke After Trampoline Use.

    Science.gov (United States)

    Casserly, Courtney S; Lim, Rodrick K; Prasad, Asuri Narayan

    2015-11-01

    The aim of this study was to report a case of a 4-year-old boy who had been playing on the trampoline and presented to the emergency department (ED) with vomiting and ataxia, and had a vertebral artery dissection with subsequent posterior circulation infarcts. This study is a chart review. The patient presented to the emergency department with a 4-day history of vomiting and gait unsteadiness. A computed tomography scan of his head revealed multiple left cerebellar infarcts. Subsequent magnetic resonance imaging/magnetic resonance angiogram of his head and neck demonstrated multiple infarcts involving the left cerebellum, bilateral thalami, and left occipital lobe. A computed tomography angiogram confirmed the presence of a left vertebral artery dissection. Vertebral artery dissection is a relatively common cause of stroke in the pediatric age group. Trampoline use has been associated with significant risk of injury to the head and neck. Patients who are small and/or young are most at risk. In this case, minor trauma secondary to trampoline use could be a possible mechanism for vertebral artery dissection and subsequent strokes. The association in this case warrants careful consideration because trampoline use could pose a significant risk to pediatric users.

  16. Vertebral Artery Dissection Leading to Fornix Infarction: A Case Report.

    Science.gov (United States)

    Kurokawa, Takashi; Baba, Yasuhisa; Fujino, Kimihiro; Kuroiwa, Yoshiyuki; Tomita, Yusuke; Nakane, Makoto; Yamada, Shoko Merrit; Tanaka, Fumiaki

    2015-07-01

    The subcallosal artery is a proximal branch of the anterior communicating artery and has been recognized as the vessel responsible for fornix infarction. Fornix infarction caused by vascular damage to the posterior circulation has not been reported previously. A 26-year-old woman suffered from fornix infarction due to artery-to-artery embolism after vertebral artery dissection. Cerebral infarctions were also found in the left thalamus, body of the left caudate nucleus, and the left occipital lobe other than the fornix. Occlusion of the subcallosal artery results in cerebral infarction of fornix, anterior cingulate cortex, and genu of the corpus callosum. However, in our case, lesions were restricted to the territory of posterior circulation. In addition to subcallosal artery, lateral posterior choroidal artery, a perforating branch of the posterior cerebral artery, has been described to send branches to the fornix, so we speculated that the left lateral posterior choroidal artery was actually responsible for fornix infarction. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Giant vertebral artery aneurysm in a child treated with endovascular parent artery occlusion and coil embolization.

    Science.gov (United States)

    Park, Hun-Soo; Nakagawa, Ichiro; Wada, Takeshi; Nakagawa, Hiroyuki; Hironaka, Yasuo; Kichikawa, Kimihiko; Nakase, Hiroyuki

    2014-01-01

    Intracranial giant vertebral artery aneurysms are extremely rare in the pediatric population and are associated with significant morbidity and mortality. The present report describes a case of a pediatric patient with giant vertebral artery aneurysm who presented with intracranial mass effect. This patient was successfully treated with endovascular parent artery occlusion and coil embolization. A 7-year-old girl presented with tetraparesis, ataxia, dysphagia, and dysphonia. Cerebral angiography revealed intracranial giant aneurysm arising from the right vertebral artery. The patient underwent endovascular parent artery occlusion alone to facilitate aneurysmal thrombosis as an initial treatment. This was done to avoid a coil mass effect to the brainstem. However, incomplete thrombosis occurred in the vicinity of the vertebral artery union. Therefore, additional coil embolization for residual aneurysm was performed. Two additional coil embolization procedures were performed in response to recurrence. Mass effect and clinical symptoms gradually improved, and the patient had no associated morbidity or recurrence at 2 years after the last fourth coil embolization. Intracranial giant vertebral artery aneurysms are rare and challenging in pediatric patients. Staged endovascular strategy can be a safe and effective treatment option.

  18. Risk factors for vertebral artery injuries in cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Nanjundappa S. Harshavardhana

    2014-10-01

    Full Text Available Blunt cerebrovascular injuries (i.e. involvement of carotid and vertebral arteries are increasingly being recognized in setting of cervical spine trauma/fractures and are associated with high incidence of stroke/morbidity and mortality. The incidence of vertebral artery injuries (VAI is more common than previously thought and regular screening is seldom performed. However there exists no screening criteria and conflicting reports exists between spine and trauma literature. Many clinicians do not routinely screen/evaluate patients presenting with cervical spine trauma for potential VAI. This article provides a brief summary of existing evidence regarding the incidence of VAI in the background of cervical trauma/fractures. The type and fracture pattern that is associated with a high risk of VAI warranting mandatory screening/further work-up is discussed. A brief overview of diagnostic modalities and their respective sensitivity/specificity along with available treatment options is also summarized.

  19. Intracranial vertebral artery dissection with subarachnoid hemorrhage following child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Pamela H.; Burrowes, Delilah M.; Ali, Saad; Shaibani, Ali [Feinberg School of Medicine of Northwestern University, Department of Radiology, Chicago, IL (United States); Bowman, Robin M. [Feinberg School of Medicine of Northwestern University, Department of Neurological Surgery, Chicago, IL (United States)

    2007-06-15

    Child abuse is often suspected based on particular patterns of injury. We report a case of intracranial vertebral artery dissection with subarachnoid hemorrhage (SAH) in a 3-month-old boy following child abuse. The mechanisms of injury and the clinical and imaging findings are discussed. This particular pattern of injury has rarely been reported in association with child abuse. We hope to raise physician awareness of child abuse when faced with these imaging findings. (orig.)

  20. Vertebral artery dissection after iatrogenic cervical subcutaneous emphysema.

    Science.gov (United States)

    Rabkin, David G; Benharash, Peyman; Shemin, Richard J

    2011-01-01

    We report a case of spontaneous vertebral artery dissection (VAD) in a patient who developed extensive subcutaneous emphysema following the removal of a chest tube after a cardiac transplant. The pathophysiology and management of this uncommon complication are reviewed. Although vertebral and carotid artery dissections are unusual events occurring in 2.5 to 3 per 100,000 people, they are increasingly acknowledged to be important causes of stroke in the young and middle-aged adult population accounting for up to 25% of such cases. VADs are associated with a variety of minor traumatic mechanisms including painting a ceiling, yoga, chiropractic manipulation of the spine, and driving. These events cause injury to the vessel wall either by shearing forces secondary to rotational injuries or direct trauma to the vessel wall on bony prominences, especially the transverse processes of the cervical vertebrae. We present a case of a patient with documented previously normal vertebral arterial anatomy who developed a VAD after mediastinal tube removal resulted in subcutaneous emphysema tracking through fascial planes into his neck. © 2010 Wiley Periodicals, Inc.

  1. Cerebellar cortical infarct cavities and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Cocker, Laurens J.L. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kliniek Sint-Jan Radiologie, Brussels (Belgium); Compter, A.; Kappelle, L.J.; Worp, H.B. van der [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Luijten, P.R.; Hendrikse, J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2016-09-15

    Cerebellar cortical infarct cavities are a newly recognised entity associated with atherothromboembolic cerebrovascular disease and worse physical functioning. We aimed to investigate the relationship of cerebellar cortical infarct cavities with symptomatic vertebrobasilar ischaemia and with vascular risk factors. We evaluated the MR images of 46 patients with a recent vertebrobasilar TIA or stroke and a symptomatic vertebral artery stenosis ≥50 % from the Vertebral Artery Stenting Trial (VAST) for the presence of cerebellar cortical infarct cavities ≤1.5 cm. At inclusion in VAST, data were obtained on age, sex, history of vertebrobasilar TIA or stroke, and vascular risk factors. Adjusted risk ratios were calculated with Poisson regression analyses for the relation between cerebellar cortical infarct cavities and vascular risk factors. Sixteen out of 46 (35 %) patients showed cerebellar cortical infarct cavities on the initial MRI, and only one of these 16 patients was known with a previous vertebrobasilar TIA or stroke. In patients with symptomatic vertebrobasilar ischaemia, risk factor profiles of patients with cerebellar cortical infarct cavities were not different from patients without these cavities. Cerebellar cortical infarct cavities are seen on MRI in as much as one third of patients with recently symptomatic vertebral artery stenosis. Since patients usually have no prior history of vertebrobasilar TIA or stroke, cerebellar cortical infarct cavities should be added to the spectrum of common incidental brain infarcts visible on routine MRI. (orig.)

  2. Age-dependent leiomuscular atrophy in vertebral arteries of individuals under low fat diet.

    Science.gov (United States)

    Zeiser, R; Albrecht-Bellingrath, W; Schaefer, H E

    2000-01-01

    The volumetric density of vascular smooth muscle cells (VSMC) in the proximal vertebral artery was investigated. In order to identify VSMC, paraffin-embedded sections of the proximal vertebral artery, obtained from autopsy specimens, were immunostained for smooth muscle alpha-actin by a modified ABC-technique. The 63 autopsy specimens, including 35 males and 28 females, covered the entire range from 2 months to 85 years. The volumetric density of alpha-actin positive VSMC in the tunica media was morphometrically assayed by the point-counting method. It is important to note that the morphometrical evaluation was performed on arteries obtained from autopsy specimens of the years 1953/54, a post-war time characterized in Germany by low fat diet as compared to the present-day nutrition of most industrial nations. Probably due to their origin, the vertebral arteries showed almost no atheroma. As the main purpose of this study was to find out about the atherosclerosis-independent process of aging, these arteries seemed particularly suitable. The evaluation showed a strictly age-dependent leiomuscular atrophy which became morphometrically evident in early adulthood. The average degree of regression was measured at 0.62% per year. These results may justify the conclusion that the leiomuscular atrophy of the media represents a primary age-related process and does not in any way result as a secondary event from an atheromatous transformation of the intima.

  3. The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures

    Directory of Open Access Journals (Sweden)

    Farzanah Ismail

    2013-06-01

    Full Text Available Aim: It is not uncommon for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth vertebral bodies. Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA in patients with cervical spine fractures.Method: A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist.Results: The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury, had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 to C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations.Conclusion: Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.

  4. The pattern and prevalence of vertebral artery injury in patients with ...

    African Journals Online (AJOL)

    Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA) in patients with cervical spine fractures. Method.

  5. Extracranial vertebral artery dissection in children: natural history and management.

    Science.gov (United States)

    Simonnet, Hina; Deiva, Kumaran; Bellesme, Céline; Cabasson, Sébastien; Husson, Béatrice; Toulgoat, Frédérique; Théaudin, Marie; Ducreux, Denis; Tardieu, Marc; Saliou, Guillaume

    2015-07-01

    The objective of this study is to describe clinical and imaging presentation and outcome in extracranial vertebral artery dissection. Single-centre retrospective study over a 14-year period included 20 consecutive patients under the age of 16 years with extracranial vertebral artery dissection. The diagnosis was based on vascular imaging performed at the acute phase and clinical symptoms. A male predominance was observed (sex ratio 9/1). The first symptoms consisted of headache (45%), neck pain (15%), nausea (30%) and vertigo (30%). Clinical signs leading to admission to hospital were hemiparesis (60%), visual disorders with oculomotor disorders (20%) or visual field defects (20%) and cerebellar syndrome (35%). Eight patients (40%) reported repeated transient episodes of neurological deficits, prior to the diagnosis. The segment most commonly affected was V2-V3 (50%), followed by V3 (15%) and V2 (15%), V3-V4 (10%) and proximal V4 (10%). All patients but one presented cerebral infarction. Eleven patients received first-line treatment with low molecular weight heparin (LMWH), and nine patients received aspirin. Three patients experienced a recurrence of symptoms, one under vitamin K antagonist (VKA) and 2 under aspirin. All three were switched to LMWH with success. Fifty-eight percent of the dissected arteries were occluded at long-term follow-up, although 73% of them were patent at the acute phase. Initial imaging must include posterior fossa vessels and the craniocervical region with V2-V3 segments. Conventional angiography may be indicated in the absence of a definitive diagnosis on noninvasive imaging. Healing of the dissected vertebral artery predominantly resulted in occlusion, which does not constitute a pejorative factor but indicates good quality healing.

  6. Conodonts, Calcichordates and the Origin of Vertebrates

    Directory of Open Access Journals (Sweden)

    J. Bergström

    1998-01-01

    Full Text Available Interpretation of early deuterostome evolution and relationships has been hampered by the lack of soft-part preservation in most groups. In addition, a recently revealed upside-down life orientation of vertebrates (the only real notoneuralians compared to other bilateral animals has been misinterpreted as evidence for a unique body design in all deuterostomes, misleading any search for relatives. Regarding echinoderms, the variety of body plans is confusing. The interpretation of some fossils with echinoderm-type calcite skeletons as “calcichordate” ancestors of chordates, however, involves a hypothetical reconstruction of an unusual body plan and a long series of hypothetical transitions. The number of necessary steps is much lower if cephalochordates (amphioxus or lancelet are derived directly from hemichordate enteropneusts. “Sensation interpretations” of fossils (Yunnanozoon, Cathaymyrus from Burgess Shale type deposits have added further confusion. Soft-part preservation of conodont animals, with V-shaped myomeres and a notochord, shows that they were segmented chordates, while probable eyes and teeth suggest that they were already on the vertebrate side. Die Interpretation früher Deuterostomia hinsichtlich ihrer Evolution und verwandtschaftlichen Beziehungen ist in den meisten Gruppen durch den Mangel an Weichkörpererhaltung sehr erschwert. Die kürzlich entdeckte Tatsache, daß Vertebraten, d. h. die einzigen echten Notoneuralia, im Gegensatz zu anderen bilateral symmetrischen Organismen eine mit ihrer ursprünglichen Oberseite nach unten gerichtete Lebensstellung einnehmen, hat zu der irrtümlichen Ansicht geführt, daß alle Deuostomia über einen im Tierreich einzigartigen Bauplan verfügen. Diese Interpretation brachte naturgemäß jede Suche nach Verwandtschaftsverhältnissen auf Abwege. Hinsichtlich der Echinodermata ist die bauplanmäßige Variation in der Tat verwirrend. Die Interpretation einiger Fossilien mit

  7. Neurorehabilitation in stroke produced by vertebral artery dissection: case presentation

    Directory of Open Access Journals (Sweden)

    Stanescu Ioana

    2018-02-01

    Full Text Available Arterial dissections are a common cause of stroke in the young (mean age 44 to 46 years. Primary lesion is a tear of the arterial intima, which promotes platelet aggregation, thrombus formation, which further produced vessel stenosis / occlusion, distal embolism or vessel wall rupture. Vertebral artery (VA dissection appear most commonly in extracranial segments V2 and V3, and could be spontaneous (with underlying predispositions or triggered by various traumatisms. Clinicaly, VA dissection produces an ischemic stroke or transient ischemic attack , preceded by local symptoms such as neck pain or headache. The diagnosis is confirmed by neurovascular imaging. Treatment of symptomatic VA dissections respect indications of treatment in ischemic strokes. Prognosis is mostly favorable in extracranial dissections. We present the case of a left VA dissection in V2 segment, produced by physical effort (swimming, which causes 2 ischemic lesions, one in the territory of the left posterior cerebral artery and the other in the territory of the left posterolateral chorroidal artery. Patient’s treatment included antiplatelet agents, statines, and an adapted physical rehabilitation program. At three months he showed significant clinical improvement with regain of autonomy and partial recanalisation at angio-MRI of the V2 segment of the dissected artery.

  8. A Vertebral Artery Dissection with Basilar Artery Occlusion in a Child

    Directory of Open Access Journals (Sweden)

    Katleen Devue

    2014-01-01

    Full Text Available This paper presents the case report of an 11-year-old boy with an acute dissection with thrombosis of the left vertebral artery and thrombosis of the basilar artery. The patient was treated with acute systemic thrombolysis, followed by intra-arterial thrombolysis, without any clinical improvement, showing left hemiplegia, bilateral clonus, hyperreflexia, and impaired consciousness. MRI indicated persistent thrombosis of the arteria basilaris with edema and ischemia of the right brainstem. Heparinization for 72 hours, followed by a two-week LMWH treatment and subsequent oral warfarin therapy, resulted in a lasting improvement of the symptoms. Vertebral artery dissection after minor trauma is rare in children. While acute basilar artery occlusion as a complication is even more infrequent, it is potentially fatal, which means that prompt diagnosis and treatment are imperative. The lack of class I recommendation guidelines for children regarding treatment of vertebral artery dissection and basilar artery occlusion means that initial and follow-up management both require a multidisciplinary approach to coordinate emergency, critical care, interventional radiology, and child neurology services.

  9. [Revascularization of the carotid and vertebral arteries in the elderly].

    Science.gov (United States)

    Illuminati, G; Bezzi, M; D'Urso, A; Giacobbi, D; Ceccanei, G; Vietri, F

    2004-01-01

    From January 1994 to July 2004, 323 patients underwent 348 revascularization of carotid bifurcation for atherosclerotic stenoses. Eighty eight patients (group A) were 75 year-old or older, whereas 235 (group B) were younger than 75 years. Postoperative mortality/neurologic morbidity rate was 1% in group A, and 1.4% in group B. At 5 years, patency and freedom from symptoms/stroke were, respectively, 91% and 92% in group A, and 89% and 91% in group B. None of these differences was statistically significant. In the same time period, 26 internal carotid arteries were revascularized in 24 patients, 75 or more aged, for a symptomatic kinking. Postoperative mortality/morbidity rate was absent, whereas, at 5 years, patency and freedom from symptoms/stroke were, respectively, 88% and 92%. Twelve vertebral arteries were revascularized in 12 patients, 75 or more aged, for invalidating symptoms of vertebrobasilar insufficiency. Postoperative mortality/neurologic morbidity rate was absent. In one case postoperative recurrence of symptoms occurred, despite a patent revascularization. Patency and freedom from symptoms/stroke were 84% and 75%, at 5 years. Revascularization of carotid and vertebral arteries in the elderly can be accomplished with good results, superposable to those of standard revascularization of carotid bifurcation in a younger patients' population.

  10. [The Efficacy of Percutaneous Transluminal Angioplasty and Stenting for Traumatic Vertebral Artery Dissection due to Cervical Vertebral Fracture].

    Science.gov (United States)

    Kawaguchi, Misato; Nii, Kouhei; Sakamoto, Kimiya; Kawahara, Kanae; Inoue, Ritsurou; Hiraoka, Fumihiro; Morinaga, Yusuke; Mitsutake, Takafumi; Hanada, Hayatsura; Tsutsumi, Masanori

    2018-02-01

    A 73-year-old man was admitted at another hospital after a traffic accident. The diagnosis was cervical vertebral fracture. Despite conservative treatment, 5 days later he manifested dysarthria due to cerebellar infarction and was transferred to our hospital. Imaging studies revealed right vertebral arterial dissection at the level of the axial fracture. We performed percutaneous transluminal angioplasty with stenting to address his subacute vertebral artery dissection prior to treating the cervical vertebral fracture using external fixation. His clinical course was good;ischemia did not recur after stenting and his dysarthria disappeared upon rehabilitation. Cerebral angiograms obtained 6 months later revealed no significant in-stent restenosis. While medical management tends to be the first-line treatment of traumatic vertebral artery dissection, percutaneous transluminal angioplasty with stenting is necessary before treating other traumatic lesions to prevent neurologic events.

  11. The origin of conodonts and of vertebrate mineralized skeletons

    Science.gov (United States)

    Murdock, Duncan J.E.; Dong, Xi-Ping; Repetski, John E.; Marone, Federica; Stampanoni, Marco; Donoghue, Philip C.J.

    2013-01-01

    Conodonts are an extinct group of jawless vertebrates whose tooth-like elements are the earliest instance of a mineralized skeleton in the vertebrate lineage, inspiring the ‘inside-out’ hypothesis that teeth evolved independently of the vertebrate dermal skeleton and before the origin of jaws. However, these propositions have been based on evidence from derived euconodonts. Here we test hypotheses of a paraconodont ancestry of euconodonts using synchrotron radiation X-ray tomographic microscopy to characterize and compare the microstructure of morphologically similar euconodont and paraconodont elements. Paraconodonts exhibit a range of grades of structural differentiation, including tissues and a pattern of growth common to euconodont basal bodies. The different grades of structural differentiation exhibited by paraconodonts demonstrate the stepwise acquisition of euconodont characters, resolving debate over the relationship between these two groups. By implication, the putative homology of euconodont crown tissue and vertebrate enamel must be rejected as these tissues have evolved independently and convergently. Thus, the precise ontogenetic, structural and topological similarities between conodont elements and vertebrate odontodes appear to be a remarkable instance of convergence. The last common ancestor of conodonts and jawed vertebrates probably lacked mineralized skeletal tissues. The hypothesis that teeth evolved before jaws and the inside-out hypothesis of dental evolution must be rejected; teeth seem to have evolved through the extension of odontogenic competence from the external dermis to internal epithelium soon after the origin of jaws.

  12. The origin of conodonts and of vertebrate mineralized skeletons.

    Science.gov (United States)

    Murdock, Duncan J E; Dong, Xi-Ping; Repetski, John E; Marone, Federica; Stampanoni, Marco; Donoghue, Philip C J

    2013-10-24

    Conodonts are an extinct group of jawless vertebrates whose tooth-like elements are the earliest instance of a mineralized skeleton in the vertebrate lineage, inspiring the 'inside-out' hypothesis that teeth evolved independently of the vertebrate dermal skeleton and before the origin of jaws. However, these propositions have been based on evidence from derived euconodonts. Here we test hypotheses of a paraconodont ancestry of euconodonts using synchrotron radiation X-ray tomographic microscopy to characterize and compare the microstructure of morphologically similar euconodont and paraconodont elements. Paraconodonts exhibit a range of grades of structural differentiation, including tissues and a pattern of growth common to euconodont basal bodies. The different grades of structural differentiation exhibited by paraconodonts demonstrate the stepwise acquisition of euconodont characters, resolving debate over the relationship between these two groups. By implication, the putative homology of euconodont crown tissue and vertebrate enamel must be rejected as these tissues have evolved independently and convergently. Thus, the precise ontogenetic, structural and topological similarities between conodont elements and vertebrate odontodes appear to be a remarkable instance of convergence. The last common ancestor of conodonts and jawed vertebrates probably lacked mineralized skeletal tissues. The hypothesis that teeth evolved before jaws and the inside-out hypothesis of dental evolution must be rejected; teeth seem to have evolved through the extension of odontogenic competence from the external dermis to internal epithelium soon after the origin of jaws.

  13. THE SPIRIT-PROCAINE PERIARTERIAL BLOCKADES APPLICATION UPON THE THIRD SEGMENT OF VERTEBRAL ARTERY IN VERTEBRAL-BASILAR INSUFFICIENCY

    Directory of Open Access Journals (Sweden)

    I.I. Sholomov

    2008-09-01

    Full Text Available The spirit-procaine blockades are pathogenicallyjustified methods oftreatmentofthe vertebral-basilarartery insufficiency caused by vertebral pathology. Chemical desympathisation of the third portion of the vertebral artery (VA can be applied as alternative to stellate ganglionectomy and blockades of stellate ganglion or periarterial plexus of the VA at the level of the sixth cervical vertebra. In case of positive effect after procaine blockade, the next stage of the treatment is the periarterial alcoholisation of vertebral arteries by low-concentrated (30° ethyl alcohol. This effect is analogous to procaine blockade, but more steadfast Clinical and ultrasound investigations proved, thatspirit-procaine blockades improve the blood flow in vertebrobasilar arterial system, reduce the peripherical resistance of the vessels and interhemispherical asymmetry, and decrease the spasm of intracranial arteries, that leads to improvementof neurological condition.

  14. [Branches of the vertebral artery to the spinal cord].

    Science.gov (United States)

    Mauppin, J M; Ndiaye, A; Lo, A; Ouedraogo, T; Sow, M L

    1990-01-01

    On the cervical level, ramifications stemming directly from the vertebral artery are studied while nevertheless taking into account contributions from rising and deep cervical, and while sometimes even from the upper intercostal and/or the occipital, as well as anastomoses contracted from these various sources at the level of the neck. No bulging cervical artery exists, but the variations observed are frequent. Pedicles are rarely symmetrical and usually alternate between left and right sides. Two, differently coloured injections sometimes reveal a preponderance for one side rather than the other, but the injections must be able to be made at the same time and with an equal degree of precision if a formal conclusion is to be drawn from this.

  15. Odontogenic Pain as the Principal Presentation of Vertebral Artery Pseudoaneurysm; a Case Report

    Directory of Open Access Journals (Sweden)

    Marco Zenteno

    2015-07-01

    Full Text Available Dissection of the vertebral artery is an important but rare cause of cerebrovascular accidents. Here we report a 48-year-old man with toothache since 4 days before who presented to the emergency department with neck pain and final diagnosis of dissecting right vertebral artery pseudoaneurysm. To our knowledge, this maybe the first report of odontogenic pain as the first manifestation of vertebral artery pseudoaneurysm in the literatures.

  16. Treatment of proximal segment stenoses of vertebral arteries with baloon expandable silicon carbide coated stents

    Directory of Open Access Journals (Sweden)

    Šeruga Tomaž

    2013-01-01

    Conclusions: Stenting of the vertebral arteries can significantly improve hemodynamic conditions in the posterior circulation and prevent recurrent transient ischemic attacks and worsening of vertebro-basilar symptoms. So far, less than twenty studies have been published on the stenting of vertebral arteries worldwide. Randomized larger prospective trials are needed to confirm the benefit of endovascular treatment of vertebral artery stenosis, also by use of drugeluting stents.

  17. Odontogenic Pain as the Principal Presentation of Vertebral Artery Pseudoaneurysm; a Case Report.

    Science.gov (United States)

    Zenteno, Marco; Alvis-Miranda, Hernando Raphael; Lee, Angel; Moscote-Salazar, Luis Rafael

    2015-01-01

    Dissection of the vertebral artery is an important but rare cause of cerebrovascular accidents. Here we report a 48-year-old man with toothache since 4 days before who presented to the emergency department with neck pain and final diagnosis of dissecting right vertebral artery pseudoaneurysm. To our knowledge, this maybe the first report of odontogenic pain as the first manifestation of vertebral artery pseudoaneurysm in the literatures.

  18. Vertebral artery dissection in a patient practicing self-manipulation of the neck.

    Science.gov (United States)

    Mosby, John S; Duray, Stephen M

    2011-12-01

    The purpose of this case report is to describe a patient who regularly practiced self-manipulation of her neck who presented with shoulder and neck pain and was undergoing a vertebral artery dissection. A 42-year-old female patient sought care for left shoulder pain with a secondary complaint of left lower neck pain. Twelve days prior, she had had "the worst headache of her life," which began in her left lower cervical spine and extended to her left temporal region. The pain was sudden and severe, was described as sharp and burning, and lasted 3 hours. She reported nausea, vomiting, and blurred vision. Initial history and examination suggested that the patient's head and neck pain was not musculoskeletal in origin, but vascular. She repeatedly requested that an adjustment be performed, but instead was referred to the local emergency department for further evaluation. Magnetic resonance angiogram revealed a dissection of the left vertebral artery from C6 to the C2-C3 interspace and a 3-mm dissecting pseudoaneurysm at the C3 level. She underwent stent-assisted percutaneous transluminal angioplasty combined with antiplatelet therapy (clopidogrel) and experienced a good outcome. This case suggests that careful history taking and awareness of the symptoms of VAD are necessary in cases of sudden head and neck pain. More research is needed on the relationship between vertebral artery dissection and self-manipulation of the neck.

  19. Comparison of self-expanding stents with distal embolic protection to balloon-expandable stents without a protection device in the treatment of symptomatic vertebral artery origin stenosis: a prospective randomized trial.

    Science.gov (United States)

    Geng, Xiaokun; Hussain, Mohammed; Du, Huishan; Zhao, Liang; Chen, Jian; Su, Wei; Ma, Linlin; Gao, Zongen; Ding, Yuchuan; Ji, Xunming

    2015-06-01

    To compare the angiographic and clinical outcomes of self-expanding stents (SES) with distal embolic protection devices (EPD) vs balloon-expandable stents (BES) without EPD in the treatment of symptomatic atherosclerotic vertebral artery ostial stenosis (VAOS). Between July 2011 and March 2013, a prospective randomized trial was conducted involving 127 patients (mean age 67.3±10.2 years; 94 men) with symptomatic VAOS randomly assigned to treatment with SES + EPD (Precise RX or RX Acculink stent + Spider FX EPD; n=61) or BES (Palmaz Blue or Resolute RX; n=66) without EPD. In-stent restenosis (ISR) >50% detected by duplex ultrasound was the primary endpoint. Technical success, clinical success, complications within 30 days, and signal intensity abnormalities on diffusion weighted imaging (DWI) after stenting were compared. The 30-day technical success rate was 95.5% (63/66) for SES+EPD vs 100% (70/70) for BES without EPD (p=0.072). DWI at 24 hours poststenting showed 2 hyperintense lesions in 2 (3.3%) SES + EPD cases and 15 hyperintense lesions in 13 (18.6%) BES patients (pEPD group vs 85.7% (60/70) for the BES group (p=0.115). The ISR was seen in 16/70 (22.9%) arteries in the BES group and 2/66 (3.1%) arteries in SES + EPD group (pEPD group (pEPD in the treatment of symptomatic VAOS is technically feasible and safe, with low rates of ISR and significantly reduced thromboembolic events on imaging when compared to BES without EPD. © The Author(s) 2015.

  20. An investigation of an autonomic innervation of the vertebral artery using monoamine histofluorescence

    Directory of Open Access Journals (Sweden)

    JA Mitchell

    2009-06-01

    Full Text Available Blood flow to the hindbrain, via the paired vertebral arteries, must be uncompromised for adequate neurological functioning of its vital centres. Therefore, it would seem unlikely that the intracranial vertebral artery would need to vasoconstrict, thus reducing its blood flow. In order to investigate the existence and location of a noradrenaline-mediated constrictor mechanism in the wall of the intracranial vertebral artery, transverse sections of ten baboon and ten monkey vessels were stained with sucrose-potassium phosphate-glyoxylic acid (counterstained with malachite-green. This method allows the visualisation of catecholaminergic nerves when the sections are exposed to ultraviolet light. In this study of primate vascular tissue, however, none of the monkey or baboon vertebral artery sections showed the presence of noradrenergic nerves in the tunica media – tunica adventitia junction or penetrating the tunica media of the arteries. These findings indicate that the intracranial vertebral artery does not have a neurogenic vasomotor function in primates.

  1. Cervical congenital spondylolytic spondylolisthesis associated with duplication of the vertebral artery: case report.

    Science.gov (United States)

    Domenicucci, Maurizio; Pescatori, Lorenzo; Marruzzo, Daniele; Colistra, Davide; Missori, Paolo

    2014-09-01

    Cervical bilateral congenital spondylolysis with spondylolisthesis is an abnormality both of congenital and mechanical origin, characterized by its primary feature, cervical bilateral spondylolysis. We are unaware of any reports describing cervical congenital spondylolytic spondylolisthesis associated with duplication of the vertebral artery. To report the case of a patient affected with cervical bilateral congenital spondylolysis with spondylolisthesis associated with duplication of the vertebral artery. A unique case report from a university hospital and a literature review. An 18-year-old man who arrived at the emergency department complaining of neck pain starting from a car accident 5 days ago. Neurologic examination and images taken by ordinary radiographs, magnetic resonance imaging (MRI) scans, ordinary computed tomography (CT) scans, and CT angiograms with three-dimensional (3D) reconstruction. Neurologic examination did not find evidence of strength deficit in upper extremities. Ordinary radiographs of the cervical spine showed spondylolisthesis of C6 and C7 and a cortical cleft between the superior and inferior articular facets of the C6 vertebra and spina bifida of the C6 and C2 vertebrae and an abnormal appearance of the remnant spinous processes of the cervical vertebrae. Magnetic resonance imaging confirmed the abnormalities that had been noted on the radiographs. Computed tomography scans of the cervical spine showed congenital spondylolytic spondylolisthesis and spina bifida of the C6 vertebra and duplication of the vertebral artery. They also showed double origins of the vertebral artery depicted by 3D angiographic reconstruction. Conservative treatment of wearing a cervical collar and receiving muscle relaxants and anti-inflammatory drugs was effective. With the pain completely subsided, the patient was discharged 5 days after arriving at the emergency department. Vascular abnormalities should be suspected and investigated in cases of congenital

  2. Vertebral Artery Diameter and Flow: Nature or Nurture.

    Science.gov (United States)

    Tarnoki, Adam Domonkos; Fejer, Bence; Tarnoki, David Laszlo; Littvay, Levente; Lucatelli, Pierleone; Cirelli, Carlo; Fanelli, Fabrizio; Sacconi, Beatrice; Fagnani, Corrado; Medda, Emanuela; Farina, Filippo; Meneghetti, Giorgio; Horvath, Tamas; Pucci, Giacomo; Schillaci, Giuseppe; Stazi, Maria Antonietta; Baracchini, Claudio

    2017-09-01

    In contrast with the carotid arteries, the vertebral arteries (VAs) show considerable variation in length, caliber, and vessel course. This study investigated whether the variation in diameter and flow characteristics of the VAs might be inherited. A total of 172 Italian twins from Padua, Perugia, and Terni (54 monozygotic, 32 dizygotic) recruited from the Italian Twin Registry underwent B-mode and pulsed-wave Doppler ultrasound assessment of their VAs. VA diameters, peak systolic velocity (PSV) and end diastolic velocity (EDV) were assessed at the level of a horizontal V2 segment. Univariate quantitative genetic modeling was performed. Fourteen percent of the sample had VA hypoplasia. Within pair correlation in monozygotic twins was higher than in dizygotics (.552 vs. .229) for VA diameter. Age- and sex-adjusted genetic effect, under the most parsimonious model, accounted for 54.7% (95% CI: 42.2-69.1%) of the variance of VA diameter, and unshared environmental effect for 45.3% (95% CI: 30.9-57.8%). No heritability was found for the PSV of VA, but shared (34.1%; 95% CI: 16.7-53.7%) and unshared (65.9%; 95% CI: 45.9-83.1%) environmental factors determined the variance. EDV of VA is moderately genetically influenced (42.4%; 95% CI: 16.1-64.9%) and also determined by the unshared environment (57.6%; 95% CI: 34.7-83.7%). The diameter of the VAs is moderately genetically determined. Different factors influence the PSV and EDV of VAs, which may highlight the complex hemodynamic background of VA flow and help to understand the vertebral flow anomalies found by ultrasound. Copyright © 2017 by the American Society of Neuroimaging.

  3. [Clinical screening of patients with cerebral arteriosclerosis combined with vertebral artery abnormalies].

    Science.gov (United States)

    Chen, Ju-Kun; Teng, Hong-Lin; Chen, Lei; Wang, Jing; Ye, Qiang; Wang, Xiao-Bo

    2012-03-01

    To explore the clinical screening and value of vertebral artery ultrasound, Transcranial doppler (TCD), Magnetic resonance angiography (MRA) and Computed tomography angiography (CTA) in the diagnosis of cerebral arteriosclerosis combined with vertebral artery abnormalies according to vertebral artery digital subtraction angiography (DSA). From January 2006 to September 2010, 186 patients with cerebral arteriosclerosis were retrospectively analyzed. Among the patients, 133 cases were males and 53 cases were females,ranged from 30 to 84 years (with a mean of 63.8 years). All the patients were estimated by DSA; 172 cases were estimated vertebral artery ultrasound and TCD; 53 cases were estimated by MRA; 25 cases were estimated by CTA. The positive results by DSA were seen as case group, while the negative results were seen as control group. The sensitivity, specificity and concordance rate among four groups were calculated. The abnormality rate of vertebral artery with DSA, vertebral artery ultrasound, TCD, MRA and CTA separately was 50.00% (93/186), 30.81% (53/172), 49.42% (85/172),15.10% (8/53) and 40.00% (10/25). According to DSA standard, the sensitivity of vertebral artery ultrasound in diagnosing was 50.57%, the specificity was 89.41%, and concordance rate was 69.77%; while the sensitivity of TCD was 68.48%, the specificity was 72.50%, and concordance rate was 70.35%; the sensitivity of MRA was 21.43%, specificity was 92.00%, and concordance rate was 54.72%; the sensitivity of CTA was 63.64%,the specificity was 78.57%, and concordance rate was 72.00%. The reasonable and combined application of vertebral artery ultrasound, TCD, MRA and CTA is helpful for diagnosing cerebral arteriosclerosis combined with vertebral artery abnormalies. For the patients with cerebrovascular disease, cervical massage technique should be paid highly attention, which may cause vertebral artery injury and other complications.

  4. Operative and endovascular management of extracranial vertebral artery aneurysm in Ehlers-Danlos syndrome:a clinical dilemma--case report and literature review.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2002-01-01

    The most prevalent lesion of the vertebral artery is an atheromatous plaque located at its origin from the subclavian artery. A case of successful management of a symptomatic vertebral artery aneurysm due to Ehlers-Danlos syndrome is reported. The patient had asymptomatic posterior intracerebral artery dissection on the contralateral side. A common carotid artery to V-3 segment bypass using reversed saphenous vein graft was carried out. Avulsion of the V-2 segment occurred peroperatively and endovascular coil embolization of the vertebral artery aneurysm was performed. Endovascular equipment and training must be in the armamentarium of vascular surgeons as more complex cases are being treated, which demands new approaches for ultimate clinical success. This unique case outlines what might unexpectedly occur. Endovascular intervention as an adjuvant procedure provides a satisfactory outcome in what could have been a catastrophe.

  5. Origin and evolution of retinoid isomerization machinery in vertebrate visual cycle: hint from jawless vertebrates.

    Directory of Open Access Journals (Sweden)

    Eugenia Poliakov

    Full Text Available In order to maintain visual sensitivity at all light levels, the vertebrate eye possesses a mechanism to regenerate the visual pigment chromophore 11-cis retinal in the dark enzymatically, unlike in all other taxa, which rely on photoisomerization. This mechanism is termed the visual cycle and is localized to the retinal pigment epithelium (RPE, a support layer of the neural retina. Speculation has long revolved around whether more primitive chordates, such as tunicates and cephalochordates, anticipated this feature. The two key enzymes of the visual cycle are RPE65, the visual cycle all-trans retinyl ester isomerohydrolase, and lecithin:retinol acyltransferase (LRAT, which generates RPE65's substrate. We hypothesized that the origin of the vertebrate visual cycle is directly connected to an ancestral carotenoid oxygenase acquiring a new retinyl ester isomerohydrolase function. Our phylogenetic analyses of the RPE65/BCMO and N1pC/P60 (LRAT superfamilies show that neither RPE65 nor LRAT orthologs occur in tunicates (Ciona or cephalochordates (Branchiostoma, but occur in Petromyzon marinus (Sea Lamprey, a jawless vertebrate. The closest homologs to RPE65 in Ciona and Branchiostoma lacked predicted functionally diverged residues found in all authentic RPE65s, but lamprey RPE65 contained all of them. We cloned RPE65 and LRATb cDNAs from lamprey RPE and demonstrated appropriate enzymatic activities. We show that Ciona ß-carotene monooxygenase a (BCMOa (previously annotated as an RPE65 has carotenoid oxygenase cleavage activity but not RPE65 activity. We verified the presence of RPE65 in lamprey RPE by immunofluorescence microscopy, immunoblot and mass spectrometry. On the basis of these data we conclude that the crucial transition from the typical carotenoid double bond cleavage functionality (BCMO to the isomerohydrolase functionality (RPE65, coupled with the origin of LRAT, occurred subsequent to divergence of the more primitive chordates

  6. A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

    Directory of Open Access Journals (Sweden)

    Kishi S

    2012-04-01

    Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

  7. ORIGINAL ARTICLES Peripheral arterial disease

    African Journals Online (AJOL)

    arterial disease is confirmed by its adverse prognostic significance for coronary and cerebrovascular events.2. •. 5. ·. 8 ABPI has been found to be an independent predictor even when the effects of advanced age, hypertension, diabetes mellitus, and pre-existing cardiovascular disease have been taken into account using ...

  8. Vertebral artery anomaly and injury in spinal surgery.

    Science.gov (United States)

    Molinari, Robert; Bessette, Matthew; Raich, Annie L; Dettori, Joseph R; Molinari, Christine

    2014-04-01

    Systematic review. The purpose of this review is to further define the published literature with respect to vertebral artery (VA) anomaly and injury in patients with degenerative cervical spinal conditions. In adult patients with cervical spine or degenerative cervical spine disorders receiving cervical spine surgery, what is the incidence of VA injury, and among resulting VA injuries, which treatments result in a successful outcome and what percent are successfully repaired? A systematic review of pertinent articles published up to April 2013. Studies involving traumatic onset, fracture, infection, deformity or congenital abnormality, instability, inflammatory spinal diseases, or neoplasms were excluded. Two independent reviewers assessed the level of evidence quality using the Grades of Recommendation Assessment, Development and Evaluation criteria; disagreements were resolved by consensus. From a total of 72 possible citations, the following met our inclusion criteria and formed the basis for this report. Incidence of VA injuries ranged from 0.20 to 1.96%. None of the studies reported using preoperative imaging to identify anomalous or tortuous VA. Primary repair and ligation were the most effective in treating VA injuries. The incidence of VA injuries in degenerative cervical spinal surgery might be as high as 1.96% and is likely underreported. Direct surgical repair is the most effective treatment option. The most important preventative technique for VA injuries is preoperative magnetic resonance imaging or computed tomography angiographic imaging to detect VA anomalies. The overall strength of evidence for the conclusions is low.

  9. Evaluating vertebral artery dominancy before T4 lung cancer surgery requiring subclavian artery reconstruction.

    Science.gov (United States)

    Sekine, Yasuo; Saitoh, Yukio; Yoshino, Mitsuru; Koh, Eitetsu; Hata, Atsushi; Inage, Terunaga; Suzuki, Hidemi; Yoshino, Ichiro

    2017-08-02

    To evaluate vertebral artery (VA) dominancy and the risk of brain infarction in T4 lung cancer patients with tumor invasion into the subclavian artery. We reconstructed the subclavian artery in 10 patients with T4 non-small cell lung cancer. The histological stages were IIIA in eight patients and IIIB in two patients. We evaluated the VA dominancy by performing a four-vessel study preoperatively and investigated the relationship between the methods of VA treatment and postoperative brain complications, retrospectively. Seven patients had a superior sulcus tumor (SST) and three had direct invasion into the mediastinum. Based on the tumor location, a transmanublial approach was used in five patients and a posterolateral hook incision was used in the other five. All subclavian artery (SA) reconstructions were done using an artificial woven graft. Preoperative angiography of the VA revealed poor development of the contralateral side in two patients. One of these patients suffered a severe brain infarction on postoperative day 2, which proved fatal. In the other patient, the VA was connected to the left SA graft by a side-to-end anastomosis and there was no postoperative brain complication. Preoperative SA and VA angiography is mandatory for identifying the need for VA reconstruction in lung cancer patients with major arterial invasion.

  10. Normal reference values for vertebral artery flow volume by color Doppler sonography in Korean adults

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Cha, Jang Gyu; Park, Seong Jin; Joh, Joon Hee; Park, Jai Soung; Kim, Dae Ho; Lee, Hae Kyung; Ahn, Hyun Cheol [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2003-09-15

    Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume. This study was to establish the reference values for the flow volume of the vertebral artery using color Doppler sonography in the normal Korea adults. Thirty five normal Korea adults without any underlying disease including hypertension, hyperlipidemia, diabetes, heart disease, obesity (body mas index>30), or carotid artery stenosis was included. There were 17 males and 18 females, age ranged from 20 to 53 years (average=32.86 years). Flow velocities and vessel diameters were recorded in the intertransverse (V2) segment, usually at C5-6 level, bilaterally. The flow volume (Q) was calculated. (Q=time averaged mean velocity x cross sectional area of vessel) A lower Flow velocity and smaller vessel diameter were measured on the right side compared to those of the left side, resulting in a lower flow volume. The calculated flow volumes using the equation were 77.0 +- 39.7 ml/min for the right side and 127.6 +- 71.0 ml/min for the left side (p=0.0001) while the net vertebral artery flow volume was 204.6 +- 81.8 ml/min. Decrease in the vertebral artery flow volume was statistically significant with advanced age. (r=-0.36, p=0.032). Vertebral artery blood flow volume was 191.20 +- 59.19 ml/min in male, and 217.28 +- 98.67 ml/min in female (p=0.6). The normal range for the net vertebral artery flow volume defined by the 5th to 95th percentiles was between 110.06 and 364.1 ml/min. The normal range for the net vertebral artery flow volume was between 110.06 and 364.1 ml/min. Vertebral artery flow volume decreased with the increase of age. However, gender did not affect the blood flow volume.

  11. Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

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    Davide Strambo

    2017-01-01

    Full Text Available Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1 came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

  12. Duplex ultrasonography for the detection of vertebral artery stenosis A comparison with CT angiography

    NARCIS (Netherlands)

    Rozeman, Anouk D.; Hund, Hajo; Westein, Michel; Wermer, Marieke J H; Nijeholt, Geert J. Lycklama A.; Boiten, Jelis; Schimsheimer, Robert-Jan; Algra, Ale

    Objectives Vertebrobasilar stenosis is frequent in patients with posterior circulation stroke and it increases risk of recurrence. We investigated feasibility of duplex ultrasonography (DUS) for screening for extracranial vertebral artery stenosis and compared it with CT angiography (CTA). Materials

  13. Neurofibromatosis with vertebral artery A-V fistula and cervical meningocele -a case report-

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Joo; Suh, Kyung Jin; Kim, Tae Heon; Kang, Duk Sik; Park, Yeun Mook; Park, June Sik [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of)

    1988-06-15

    Arteriovenous fistula is a rare abnormality in patient with neurofibromatosis. A review of English-language literature revealed only 3 reported cases. We report a case of neurofibromatosis with vertebral artery A-V fistula and cervical meningocele.

  14. Origins, Innovations, and Diversification of Suction Feeding in Vertebrates.

    Science.gov (United States)

    Wainwright, Peter C; McGee, Matthew D; Longo, Sarah J; Hernandez, L Patricia

    2015-07-01

    We review the origins, prominent innovations, and major patterns of diversification in suction feeding by vertebrates. Non-vertebrate chordates and larval lamprey suspension-feed by capturing small particles in pharyngeal mucous. In most of these lineages the gentle flows that transport particles are generated by buccal cilia, although larval lamprey and thaliacean urochordates have independently evolved a weak buccal pump to generate an oscillating flow of water that is powered by elastic recovery of the pharynx following compression by buccal muscles. The evolution of jaws and the hyoid facilitated powerful buccal expansion and high-performance suction feeding as found today throughout aquatic vertebrates. We highlight three major innovations in suction feeding. Most vertebrate suction feeders have mechanisms that occlude the corners of the open mouth during feeding. This produces a planar opening that is often nearly circular in shape. Both features contribute to efficient flow of water into the mouth and help direct the flow to the area directly in front of the mouth's aperture. Among several functions that have been identified for protrusion of the upper jaw, is an increase in the hydrodynamic forces that suction feeders exert on their prey. Protrusion of the upper jaw has evolved five times in ray-finned fishes, including in two of the most successful teleost radiations, cypriniforms and acanthomorphs, and is found in about 60% of living teleost species. Diversification of the mechanisms of suction feeding and of feeding behavior reveals that suction feeders with high capacity for suction rarely approach their prey rapidly, while slender-bodied predators with low capacity for suction show the full range of attack speeds. We hypothesize that a dominant axis of diversification among suction feeders involves a trade-off between the forces that are exerted on prey and the volume of water that is ingested. © The Author 2015. Published by Oxford University Press

  15. Symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zi-Liang [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China); Gao, Bu-Lang [Department of Medical Research Shijiazhuang First Hospital, Hebei Medical University (China); Li, Tian-Xiao, E-mail: litianxiaod@163.com [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China); Cai, Dong-Yang; Zhu, Liang-Fu; Bai, Wei-Xing; Xue, Jiang-Yu; Li, Zhao-Shuo [Stroke Center, Henan Provincial People’s Hospital, Zhengzhou University (China)

    2015-09-15

    Highlights: • Symptomatic vertebral artery stenosis can be treated with intracranial stenting. • Stenting for intracranial vertebral artery stenosis is safe and effective. • Stenting for intracranial vertebral artery stenosis can prevent long-term stroke. - Abstract: Purpose: To investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70–99%) concurrent with contralateral vertebral artery atherosclerotic diseases. Materials and methods: Eighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent. All the baseline, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up data were prospectively analyzed. Results: The success rate of stenting was 100%, and the mean stenotic rate was reduced from prestenting (84.9 ± 6.8)% to poststenting (17.2 ± 5.9)%. The perioperative stroke rate was 1.1%. Among eighty patients (90.9%) with clinical follow-up 8-62 months (mean 29.3 ± 17.2) poststenting, five (6.3%) had posterior circulation TIA only, three (3.8%) had mild stroke in the posterior circulation but recovered completely, and another five patients greater than 70 years old died of non-ischemic stroke. Imaging follow-up in 46 patients (52.3%) 5–54 months (mean 9.9 ± 9.9) following stenting revealed instent restenosis in 12 patients (26.1%) including 7 (58.3%) symptomatic restenosis. Age and residual stenosis were the two factors to significantly (P < 0.05) affect instent restenosis. Conclusion: Wingspan stenting in the intracranial vertebral artery atherosclerotic stenosis combined with contralateral vertebral artery atherosclerotic diseases has a low perioperative stroke rate and a good preventive effect on long-term ischemic stroke, but the instent restenosis

  16. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Directory of Open Access Journals (Sweden)

    Kae Watanabe

    2016-01-01

    Full Text Available Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors’ knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition.

  17. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

    Science.gov (United States)

    Watanabe, Kae; Rajderkar, Dhanashree A.; Modica, Renee F.

    2016-01-01

    Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors' knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition. PMID:27018080

  18. Origin of thyroid arteries in a Kenyan population | Magoma | Annals ...

    African Journals Online (AJOL)

    Introduction: The thyroid gland receives blood supply predominantly from paired superior and inferior thyroid arteries. The superior thyroid artery originates from external carotid while the inferior thyroid artery is a branch of thyrocervical trunk. Unusual origins of superior thyroid artery include common carotid and cervical part ...

  19. Successful treatment of a ruptured aneurysm at the vertebral artery-posterior inferior cerebellar artery junction and simultaneous treatment of the stenotic vertebral artery with a single flow-diverting stent: a case report.

    Science.gov (United States)

    Borota, Ljubisa; Gál, Gyula; Jonasson, Per; Ridderheim, Per-Åke

    2014-05-30

    This is the first report on the simultaneous successful treatment of a large ruptured saccular aneurysm and stenotic parent artery with a single flow-diverting stent. We report the case of a 68-year-old Caucasian man with occlusion of the right vertebral artery and a ruptured aneurysm at the junction of the left posterior inferior cerebellar artery-left vertebral artery that was successfully treated by the deployment of a single flow-diverting stent in the stenotic left vertebral artery. Stent deployment was complicated by thrombotic occlusion of the basilar artery, which was successfully reopened. The patient recovered completely, and follow-up angiography at 4 months and 1 year showed patent vertebral artery with gradual shrinkage of the aneurysm. This report contributes to the literature on treatment of large ruptured aneurysms localized in stenotic arteries and in areas of the endocranium where a mass of embolic material in the aneurysm (coils) might compromise the circulation in the parent blood vessel or compress vital brain structures.

  20. Vertebral artery terminating in posterior inferior cerebellar artery: A normal variation with clinical significance.

    Directory of Open Access Journals (Sweden)

    I-Wen Liu

    Full Text Available A vertebral artery (VA terminating in a posterior inferior cerebellar artery (PICA is often considered to be a normal variation associated with VA hypoplasia. We aimed to investigate the clinical significance of this cerebrovascular variant. A total of 80 patients with clinically evident cerebrovascular events in posterior circulation were examined by duplex sonography and magnetic resonance angiography (MRA. Eighty healthy subjects who had MRA check-up were recruited as controls. PICA termination of the VA (PICA-VA was identified as the VA not communicating with the basilar artery (BA but ending into a PICA. We compared the prevalence of PICA-VA and associated hemodynamic parameters between the patients with and without PICA-VA, and investigated their relationships with VA hypoplasia. The prevalence of PICA-VA was higher in the patient group than in the controls (18.7% vs. 6.3%, p = 0.015. Most measurements (73.3% of PICA-VA did not fit the criteria of VA hypoplasia. In comparison with the non-PICA-terminating group, the PICA-VA has a smaller diameter (3.7 ± 0.7 mm vs. 3.0 ± 0.5 mm, p < 0.001, lower mean velocity (241 ± 100 mm/sec vs. 164 ± 88 mm/sec, p < 0.01, and higher pulsatility index (1.3 ± 0.5 vs. 1.9 ± 0.6, p < 0.001. Moreover, a smaller diameter of the BA (3.2 ± 0.5 mm vs. 2.5 ± 0.9 mm, p = 0.004 and the posterior cerebral artery (PCA (2.0 ± 0.1 mm vs. 1.6 ± 0.1 mm, p = 0.006 were also noted in the PICA-VA group. The higher prevalence of PICA-VA in the patient group with smaller diameter of VA, BA and PCA reflected its clinical significance, suggesting that PICA-VA may have a detrimental impact on cerebral hemodynamics. However, the sample is small, and further studies are needed with larger sample size for confirmation.

  1. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  2. Interventional and surgical treatment of a hemothorax caused by a ruptured vertebral artery in a patient with neurofibromatosis type I

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hoon; Kim, Dong Hun; Kim, Dong Hyun; Seo, Hong Joo [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2014-04-15

    We report a case of a massive hemothorax arising from a ruptured vertebral artery aneurysm in a patient with neurofibromatosis type 1 suffering from sudden onset of dyspnea. The vertebral artery aneurysm was treated with endovascular coil embolization. Then, an open thoracotomy was performed to evacuate the hematoma.

  3. Detection of vessel wall calcifications in vertebral arteries using susceptibility weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Lisa C.; Boeker, Sarah M.; Bender, Yvonne Y.; Fallenberg, Eva M.; Wagner, Moritz; Hamm, Bernd; Makowski, Marcus R. [Department of Radiology, Charite, Berlin (Germany); Liebig, Thomas [Department of Neuroradiology, Charite, Berlin (Germany)

    2017-09-15

    Calcification of the brain supplying arteries has been linked to an increased risk for cerebrovascular disease. The purpose of this study was to test the potential of susceptibility weighted MR imaging (SWMR) for the detection of vertebral artery calcifications, based on CT as a reference standard. Four hundred seventy-four patients, who had received head CT and 1.5 T MR scans with SWMR, including the distal vertebral artery, between January 2014 and December 2016, were retrospectively evaluated and 389 patients were included. Sensitivity and specificity for the detection of focal calcifications and intra- and interobserver agreement were calculated for SWMR and standard MRI, using CT as a standard of reference. The diameter of vertebral artery calcifications was used to assess correlations between imaging modalities. Furthermore, the degree of vessel stenosis was determined in 30 patients, who had received an additional angiography. On CT scans, 40 patients showed a total of 52 vertebral artery calcifications. While SWMR reached a sensitivity of 94% (95% CI 84-99%) and a specificity of 97% (95% CI 94-98%), standard MRI yielded a sensitivity of 33% (95% CI 20-46%), and a specificity of 93% (95% CI 90-96%). Linear regression analysis of size measurements confirmed a close correlation between SWMR and CT measurements (R {sup 2} = 0.74, p < 0.001). Compared to standard MRI (ICC = 0.52; CI 0.45-0.59), SWMR showed a higher interobserver agreement for calcification measurements (ICC = 0.84; CI 0.81-0.87). For detection of distal vertebral artery calcifications, SWMR demonstrates a performance comparable to CT and considerably higher than conventional MRI. (orig.)

  4. De Novo Vertebral Artery Dissection after Endovascular Trapping for Ruptured Dissecting Internal Carotid Artery Aneurysm: Case Report

    Science.gov (United States)

    HORIE, Nobutaka; SADAKATA, Eisaku; IZUMO, Tsuyoshi; HAYASHI, Kentaro; MORIKAWA, Minoru; NAGATA, Izumi

    The authors present an extremely rare case of a 54-year-old female patient with subarachnoid hemorrhage due to a rupture of a dissecting internal carotid artery (ICA) aneurysm, who developed de novo vertebral artery dissection in the spasm period after endovascular trapping of the ICA. Interestingly, postoperative cardiopulmonary monitoring showed high global end-diastolic volume index and mean arterial pressure, which could contribute to this de novo dissection via hemodynamic stress in the cerebral circulation. Spontaneous intracranial artery dissection of more than two arteries is rare, and we believe this is the first case of de novo dissection occurring on a circulating vessel different from that of the initial dissection. The clinical implications are discussed in relation to postoperative hemodynamic stress with a review of the literature. PMID:24418785

  5. [Extracranial vertebral artery aneurysm complicating Klippel-Feil syndrome: case report].

    Science.gov (United States)

    Shimizu, S; Kojima, T; Morooka, Y; Tanaka, K; Nakagawa, Y; Kuroki, M

    1996-10-01

    The Klippel-Feil syndrome is one of the spinal malformations characterized by fusion of the cervical vertebrae. It is well known that the malformation can cause some neurologic disorders. However, an aneurysm in the vertebral artery associated with the Klippel-Feil syndrome is extremely rare, with only one case having been reported in the literature. We present a 39-year-old female with a sudden onset of disturbed consciousness. Lateral cervical x-ray films showed the Klippel-Feil syndrome and hypermobility between C1 and C2. MRI showed multiple infarctions in the posterior circulation, including bilateral thalami. Right vertebral angiogram identified the extracranial vertebral artery aneurysm as the source of the emboli. The patient gradually recovered with conservative therapy. The aneurysm was thought to be produced by chronic arterial trauma secondary to excessive movement between C1 and C2. We conclude that an extracranial vertebral artery aneurysm is a serious complication in a patient with the Klippel-Feil syndrome.

  6. A case of vertebral artery dissection associated with morning blood pressure surge.

    Science.gov (United States)

    Eguchi, Kazuo; Tachikawa, Yuichi; Kashima, Ryuichi; Shinohara, Michi; Fukushima, Fumiya; Sato, Takashi; Takeda, Akira; Numao, Toshio; Numao, Toshiro; Kario, Kazuomi; Shimada, Kazuyuki

    2005-10-01

    We report a case of a middle-aged man who suffered a cerebral infarction resulting from dissection of a vertebral artery associated with morning blood pressure surge. A 56-year-old man was transferred to our hospital with dizziness and vomiting in the early morning on a cold day in winter. He reported that he had been standing in front of the sink after bathing when he suddenly felt dizzy and fell down. He did not lose consciousness, and by the time he reached the hospital by ambulance, his dizziness had subsided, but he complained of severe headache and vomited 3 times. On admission, he was alert, and there were no neurological or radiological abnormalities (CT, MR angiography) in the brain. However, infarction in the left cerebellar hemisphere was detected by brain MRI on the 5th day of hospitalization. String sign of the left vertebral artery was noted by angiography, confirming the diagnosis of dissection of the left vertebral artery. Ambulatory blood pressure monitoring was performed after discharge. Although the mean 24-h blood pressure was in the normal range, a marked morning blood pressure rise was observed. We speculated that the acute rise of blood pressure in the early morning might have contributed to the dissection of the vertebral artery.

  7. Vertebral Fractures and Spondylosis in Men - Original Investigation

    Directory of Open Access Journals (Sweden)

    Selmin Gülbahar

    2008-04-01

    Full Text Available Aim: The aim of this study was to investigate the relationship between vertebral fractures and spondylosis and bone mineral density in men older than 60 years. Material and Method: Thirty-two men with back and low back pain aged over 60 years were included into the study. Thoracic and lumbar spine radiographs were taken and, anterior, central and posterior heights of each vertebral body from T4 to L5 was measured and than the number of vertebral fractures was assessed. Osteophyte and disc scores were used for evaluation of spondylosis. Bone mineral density was measured by dual-energy-X-ray absorptiometry. Measurements were obtained from lumbar vertebrae and proximal femoral region. Results: Significant positive correlations were found between vertebral fracture and osteophyte score and bone mineral density of total femoral region. When osteophyte score and total femoral bone mineral density were taken into consideration, there were no significant correlations between other parameters and vertebral fracture. Significant positive correlations were observed between osteophyte score and bone mineral density and t scores of L1-4. Also there were significant positive correlations between disc score and both bone mineral density and t scores of L1-4. Significant positive correlation was also found between femoral bone density and body weight. Conclusion: Finally, lumbar bone mineral density increases with spinal degenerative changes, but the increase in bone mineral density can not prevent sub clinic vertebral fractures. Especially, in the men who have intensive spinal degenerative changes, the measurement of lumbar bone mineral density is not enough for determining the fracture risk. Measurement of femoral bone mineral density and evaluation of clinic risk factors are more important for determining the fracture risk. (From the World of Osteoporosis 2008;14:1-6

  8. Vertebral Artery Caught in the Fracture Gap after Traumatic C2/3 Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Ralf Henkelmann

    2017-01-01

    Full Text Available Background Context. Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap. Purpose. Presentation of a case with follow-up until end of treatment. Study Design. Case report. Methods. A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment. Radiological diagnostics revealed a traumatic C2/3 spondylolisthesis. A computer tomography (CT angiographic scan showed a dislocation of the right vertebral artery into the fracture gap without injury to the artery. Open reduction and osteosynthesis were considered of too high risk. Therefore, we conducted fracture treatment with closed reduction and halo fixation. After removal of the halo fixator, the patient was given a soft cervical collar and was advised to rest for additional 6 weeks before beginning gradual activity. Results. Conventional follow-up revealed osseous consolidation and a CT angiographic scan showed consistent blood flow to the artery. Conclusion. Halo fixation was a safe and effective therapy strategy in the case of vertebral artery entrapment after traumatic C2 spondylolisthesis.

  9. Vascular Pathology in the Extracranial Vertebral Arteries in Patients with Acute Ischemic Stroke

    DEFF Research Database (Denmark)

    Bentsen, L; Nygård, A; Ovesen, C

    2014-01-01

    INTRODUCTION: Vascular pathology in the extracranial vertebral arteries remains among the possible causes in cryptogenic stroke. However, the diagnosis is challenged by the great variety in the anatomy of the vertebral arteries, clinical symptoms and difficulties in the radiological assessments....... METHOD: The analysis was based on 657 consecutive patients with symptoms of acute stroke and a final diagnosis of ischemic stroke or transient ischemic attack. On admission, a noncontrast CT cerebrum and CTA were performed. A senior consultant neuroradiologist, blinded to clinical data, reviewed all CTA...... (2.8%) with pathological findings had an unknown cause of stroke, likely posterior symptoms and no clinical stroke symptoms from the anterior circuit. Of these, 3 cases were kinked arteries (0.5%) and 15 cases (2.3%) were possible dissections. CONCLUSION: We found that in approximately 3...

  10. Surgical considerations in posterior C1-2 instrumentation in the presence of vertebral artery anomalies: case illustration and review of literature.

    Science.gov (United States)

    Tan, Lee A; Kasliwal, Manish K; Gerard, Carter S; Traynelis, Vincent C; Fontes, Ricardo B V

    2017-06-29

    Vascular anomalies involving the V3 segment of the vertebral artery are common and may complicate posterior atlantoaxial instrumentation. We report a patient with a fenestrated vertebral artery that underwent successful C1-2 instrumentation and fusion. Various vertebral artery anomalies are discussed with a review of pertinent literature.

  11. Posterior communicating artery giving rise to a shared-origin anterior choroidal artery: case illustration.

    Science.gov (United States)

    Tonetti, Daniel A; Andrews, Edward G; Stabingas, Kristen; Tyler-Kabara, Elizabeth; Gross, Bradley A; Jadhav, Ashutosh

    2017-10-27

    The origin point of the anterior choroidal artery is variable, typically arising from the supraclinoid internal carotid artery (ICA) distal to the posterior communicating artery (PComA) on either the posterolateral or posterior aspect of the ICA. Variations of anterior choroidal artery origin have important clinical implications, and rare origins previously reported include the internal carotid artery bifurcation or from the middle cerebral artery. We provide illustrations of a case of a shared-origin posterior communicating artery and anterior choroidal artery. A young girl presented with intracranial hemorrhage and underwent angiography to evaluate for an underlying cause. Ultimately, three-dimensional rotational angiography incidentally demonstrated a common origin of the anterior choroidal artery with the posterior communicating artery. A rare case of a shared-origin anterior choroidal artery and posterior communicating artery is reported for angiographic illustration. The radiological findings, embryology behind the development of the anterior choroidal artery, and the neurosurgical and neurovascular relevance of this variant are discussed. The importance of recognizing the origin of the anterior choroidal artery is emphasized. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Surgical resection of neoplastic cervical spine lesions in relation to the vertebral artery V2 segment

    Directory of Open Access Journals (Sweden)

    Moh'd Al Barbarawi

    2010-05-01

    Full Text Available Neoplastic cervical spine lesions are seen infrequently by the spinal surgeon. The surgical management of these tumors, particularly with associated neurovascular compromise, is challenging in terms of achieving proper resection and spinal stabilization and ensuring no subsequent recurrence or failure of fixation. In this report we highlight some of the problems encountered in the surgical management of tumors involving the cervical spine with techniques applied for gross total resection of the tumor without compromising the vertebral arteries. Ten patients with neoplastic cervical spine lesions were managed in our study. The common cardinal presentation was neck and arm pain with progressive cervical radiculo-myelopathy. All patients had plain X-rays, computer tomography scans, and magnetic resonance imaging of the cervical spine. Digital subtraction or magnetic resonance angiograms were performed on both vertebral arteries when the pathology was found to be in proximity to the vertebral artery. When a tumor blush with feeders was evident, endovascular embolization to minimize intraoperative bleeding was also considered. A single approach or a combined anterior cervical approach for corpectomy and cage-with-plate fixation and posterior decompression for resection of the rest of the tumor with spinal fixation was then accomplished as indicated. All cases made a good neurological recovery and had no neural or vascular complications. On the long-term follow-up of the survivors there was no local recurrence or surgical failure. Only three patients died: two from the primary malignancy and one from pulmonary embolism. This report documents a safe and reliable way to deal with neoplastic cervical spine lesions in proximity to vertebral arteries with preservation of both arteries.

  13. Isolated origin of the left internal carotid artery from the pulmonary artery.

    Science.gov (United States)

    Hurley, Michael C; Nguyen, Pamela H; DiPatri, Arthur J; Shaibani, Ali

    2008-09-01

    The authors describe what is, to their knowledge, the first reported case of the anomalous origin of an internal carotid artery from the pulmonary artery. An otherwise asymptomatic 6-year-old girl, who presented with headaches and hypertension, underwent a comprehensive workup that revealed extensive meningeal and cerebral artery anastomoses to the left internal carotid artery--itself arising from the origin of the left pulmonary artery. This unique anatomical anomaly, caused by a disturbed pattern of aortic arch regression, resulted in a right-to-left vascular shunt into the pulmonary artery and a disturbance of intracranial artery flow patterns, complicating the management options.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Joon Ho; Kim, Man Deuk, E-mail: mdkim@yuhs.ac; Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Korea, Republic of)

    2013-02-15

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

  15. Stroke due to a fusiform aneurysm of the cervical vertebral artery: case report

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan)]|[Department of Neurosurgery, Kyushu University Hospital 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-82 (Japan); Inoue, T. [Department of Neurosurgery, Clinical Research Institute, National Kyushu Medical Center, Fukuoka (Japan); Haga, S.; Nishio, S.; Fukui, M. [Department of Neurosurgery, Kyushu University Hospital, Fukuoka (Japan); Kono, S. [First Department of Pathology, Kyushu University Hospital, Fukuoka (Japan); Mizushima, A. [Department of Radiology, Kyushu University Hospital, Fukuoka (Japan)

    1998-01-01

    Aneurysms of the cervical vertebral artery (VA) are uncommon; they are often caused by trauma or spontaneous dissection. A fusiform aneurysm without evidence of atherosclerosis or dissection has not been reported previously. A 46-year-old man presented with a pontine infarct. Imaging revealed a fusiform aneurysm of the left VA at the C5-6 level, with occlusion of the basilar artery. Associated minor anomalies included fusion of the vertebral bodies of C5 and C6, cervical rib and platybasia. The left VA arose directly from the aortic arch and entered the transverse foramen at the C4 level. Hyperextension and left lateral flexion of the neck caused kinking of the VA proximal to the aneurysm. Turbulent flow in the aneurysm lumen was noted on angiography. (orig.) With 4 figs., 10 refs.

  16. Relative Hypodense Vertebral Artery Sign on Computerized Tomography in Atherosclerotic Near Occlusion

    Directory of Open Access Journals (Sweden)

    Muhammad Faraz Raghib

    2016-01-01

    Full Text Available A 52-year-old white male presented with an acute onset of slurred speech along with hypoesthesia in the entire left arm. The acute computed tomography (CT showed relative hypodensity in the intracranial segment of left vertebral artery (VA that was not present in historical images, pointing to the possible lack of flow. The site of occlusion was confirmed by magnetic resonance imaging (MRI that showed susceptibility effect in the affected artery. By means of historical native CT comparison the site of VA thrombosis was correctly predicted. Local atherosclerotic thrombosis of the VA could be relatively hypodense on native CT and still have positive susceptibility weighted imaging (SWI sign.

  17. Acute Hearing Loss Caused by Decreasing Anterior Inferior Cerebellar Arterial Perfusion in a Patient with Vertebral Artery Stenosis.

    Science.gov (United States)

    Fukuda, Rintaro; Miyamoto, Nobukazu; Hayashida, Arisa; Ueno, Yuji; Yamashiro, Kazuo; Tanaka, Ryota; Hattori, Nobutaka

    2017-06-01

    We report a case of bilateral hearing loss caused by decreased vascular flow in the anterior inferior cerebellar artery (AICA) territory. A 74-year-old man who experienced right hearing loss 5 months ago presented with bilateral deafness and right cerebellar ataxia; however, no ischemic lesion was detected in the bilateral AICA area. After stroke treatment, hearing loss was improved. One month later, we obtained blood flow improvement in the left AICA territory on single-photon-emission computed tomography and vertebral artery stenosis on magnetic resonance angiography. Therefore, clinicians should recognize that bilateral hearing loss may be related to stroke in the vertebrobasilar artery area. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Cerebral Lesions in Patients Undergoing Coronary Artery Bypass Grafting in Relation to Asymptomatic Carotid and Vertebral Artery Stenosis

    DEFF Research Database (Denmark)

    Wiberg, Sebastian; Schoos, Mikkel; Sillesen, Henrik

    2015-01-01

    OBJECTIVES: Carotid artery stenosis (CAS) and vertebral artery stenosis (VAS) are associated with cerebral infarction after coronary artery bypass graft surgery (CABG). It remains unclear whether this association is causal. We investigated the associations between neurologically asymptomatic CAS...... and VAS and the occurrence of subclinical cerebral lesions after CABG verified by magnetic resonance imaging. METHODS: CABG patients were included and CAS and VAS were identified by magnetic resonance angiography. Cerebral magnetic resonance imaging was performed to identify new post-operative subclinical...... cerebral lesions. The associations between CAS/VAS post-operative cerebral lesions were investigated. RESULTS: Forty-six patients were included in the study. 13% had significant CAS and 11% had significant VAS. Thirty-five percent had new cerebral infarction postoperatively. We found a significant...

  19. Extracranial vertebral artery rupture likely secondary to "cupping therapy" superimposed on spontaneous dissection.

    Science.gov (United States)

    Choi, Jae Young; Huh, Chae Wook; Choi, Chang Hwa; Lee, Jae Il

    2016-12-01

    The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication. © The Author(s) 2016.

  20. Anomalous origin of left testicular artery from an additional renal ...

    African Journals Online (AJOL)

    Gonadal arteries arising from additional renal arteries present an important variation that should be noted in order to avoid inadvertent injury to these vessels in renal hilar dissection and retroperitoneal surgery. During routine dissection, we observed the unusual origin of the left testicular artery from an additional renal ...

  1. Vertebral artery dissection complicating occipital injection of heparin for treatment of thoracic outlet syndrome.

    Science.gov (United States)

    Melinek, Judy; Hart, Amy P

    2012-03-01

    A 38-year-old woman with a 2-year history of chronic neck pain radiating down her right arm underwent radiological and neurological evaluations, which revealed no anatomical cause for her pain. She sought alternative therapies including intramuscular heparin injections. Following a right occipital injection of heparin, cyanocobalamin, and lidocaine, she had a sudden cardiorespiratory arrest and was successfully resuscitated, but did not regain consciousness.Computed tomography of the head and neck and subsequent autopsy revealed a right vertebral artery dissection, but at autopsy, no significant subarachnoid hemorrhage was noted at the base of the brain. This is the first case report where heparin (a potent anticoagulant) used in an occipital injection was documented to cause a vertebral artery dissection. It is also the first reported case where radiographically and histologically documented vertebral artery dissection did not present with overwhelming subarachnoid hemorrhage at the base of the brain. The subtle gross anatomical findings in this case highlight the importance of evaluating the cervical spinal cord in any case of sudden cardiorespiratory arrest following even apparently minor neck injury.

  2. Vertebral artery dissection presenting as a Brown-Séquard syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Miller Saul

    2009-11-01

    Full Text Available Abstract Introduction Vertebral artery dissection has become increasingly recognized as an important cause of stroke. It usually presents with posterior headache or neck pain followed within hours or days by signs of posterior circulation stroke. To the best of our knowledge, the clinical presentation of a Brown-Séquard syndrome with a vertebral artery dissection has been reported only once before. Case presentation An otherwise healthy 35-year-old man presented with acute left-sided weakness. He had experienced left-sided posterior neck pain after a 4-hour flight 4 weeks previously. Physical examination was consistent with a left Brown-Séquard syndrome. Magnetic resonance angiography showed evidence of left vertebral artery dissection. He improved after therapy with anticoagulants. Conclusion We report a case of an unusual presentation of a relatively uncommon condition. This diagnosis should be considered early in relatively young patients with stroke-like symptoms or unexplained neck pain, because missing a dissection can result in adverse outcomes.

  3. Tracing the evolutionary origin of vertebrate skeletal tissues: insights from cephalochordate amphioxus.

    Science.gov (United States)

    Yong, Luok Wen; Yu, Jr-Kai

    2016-08-01

    Vertebrate mineralized skeletal tissues are widely considered as an evolutionary novelty. Despite the importance of these tissues to the adaptation and radiation of vertebrate animals, the evolutionary origin of vertebrate skeletal tissues remains largely unclear. Cephalochordates (Amphioxus) occupy a key phylogenetic position and can serve as a valuable model for studying the evolution of vertebrate skeletal tissues. Here we summarize recent advances in amphioxus developmental biology and comparative genomics that can help to elucidate the evolutionary origins of the vertebrate skeletal tissues and their underlying developmental gene regulatory networks (GRN). By making comparisons to the developmental studies in vertebrate models and recent discoveries in paleontology and genomics, it becomes evident that the collagen matrix-based connective tissues secreted by the somite-derived cells in amphioxus likely represent the rudimentary skeletal tissues in chordates. We propose that upon the foundation of this collagenous precursor, novel tissue mineralization genes that arose from gene duplications were incorporated into an ancestral mesodermal GRN that makes connective and supporting tissues, leading to the emergence of highly-mineralized skeletal tissues in early vertebrates. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Misplaced central venous catheter in the vertebral artery: endovascular treatment of foreseen hemorrhage during catheter withdrawal.

    Science.gov (United States)

    Akkan, Koray; Cindil, Emetullah; Kilic, Koray; Ilgit, Erhan; Onal, Baran; Erbas, Gonca

    2014-01-01

    We report on the endovascular management of hemorrhage with stent-graft due to a misplaced central venous catheter in the vertebral artery (VA) during percutaneous internal jugular vein catheterization in a child. A 16-year-old female was presented with the diagnosis of familial Mediterranean fever related chronic renal insufficiency. An attempt was made to place a central venous catheter via the right internal jugular vein without image guidance and the patient experienced dyspnea and pain at the catheter insertion site. Computerized tomography (CT) showed hemorrhage in the cervical region and upper mediastinum, also reformatted images showed that the catheter was passing through the proximal part of the VA and terminating in the right mediastinum. The catheter was removed during manual compression under angio-flouroscopic monitoring and ongoing extravasation was observed. A stent-graft was placed to the bleeding site of the VA. Angiography immediately after the stent-graft placement revealed complete disappearance of extravasation and patency of vertebral and subclavian arteries. Central venous catheterization (CVC) is not a risk-free procedure and arterial injuries are in a wide spectrum from a simple puncture to rupture of the artery. Inadvertent VA cannulation is a rare and serious complication necessitating prompt diagnosis and early treatment. If an arterial injury with a large-caliber catheter occurs, endovascular treatment with stent-graft seems to be a safe and effective option in terms of achieving hemostasis and preserving arterial patency. Recent findings suggest that endovascular management of inadvertent cervical arterial injury secondary to CVC seems to be the safest strategy.

  5. Evolution and the origin of the visual retinoid cycle in vertebrates

    OpenAIRE

    Kusakabe, Takehiro G.; Takimoto, Noriko; Jin, Minghao; Tsuda, Motoyuki

    2009-01-01

    Absorption of a photon by visual pigments induces isomerization of 11-cis-retinaldehyde (RAL) chromophore to all-trans-RAL. Since the opsins lacking 11-cis-RAL lose light sensitivity, sustained vision requires continuous regeneration of 11-cis-RAL via the process called ‘visual cycle’. Protostomes and vertebrates use essentially different machinery of visual pigment regeneration, and the origin and early evolution of the vertebrate visual cycle is an unsolved mystery. Here we compare visual r...

  6. Anomalous origin of coronary artery: taxonomy and clinical implication

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2014-12-01

    Full Text Available Objective: Anomalous origin of coronary artery is uncommon. The taxonomies of anomalous origin of coronary artery are inconsistent and complex. Conceptual and therapeutic debates remain. The aim of the present study is to reappraise the concept of anomalous origin of coronary artery and to discuss the potential hazards and treatment rationale of this anomaly on basis of literature review. Methods: A comprehensive literature review was made in terms of the taxonomies including “simple”, “multiple” and “complex” types of anomalous origin of coronary artery. Results: Anomalous origin of coronary artery can be simply categorized according to the ectopically originated coronary artery. There are a couple of complex anatomical variants: “multiple” type, involving more than one coronary artery or branch, which can be subdivided into 2 subtypes, A more than one coronary arteries or branches arising from one place; and B two coronary arteries/branches arising from separate ectopic sites; and “complex” type, associated with acquired heart disease, or congenital heart defects. Conclusion: Sudden cardiac death in anomalous origin of coronary artery is associated with the anatomical features including abnormal coursing, acute angle take-off and ostial abnormalities. Atherosclerosis is prone to be in the right-sided ectopic and retroaortic coursing coronary artery. Surgical treatment is a definitive therapy. Simple coronary artery bypass grafting is not recommended due to the potential hazards of coronary steal phenomenon and poor patency of mammary arterial grafts, and modified maneuvers such as coronary ostial reimplantation, impinged coronary segment unroofing and coronary stent deployment are advocated instead.

  7. Anomalous Origin of Left Circumflex Artery

    Science.gov (United States)

    Çitaku, Hajdin; Kamberi, Lulzim; Gorani, Daut; Koçinaj, Dardan; Krasniqi, Xhevdet

    2015-01-01

    Introduction: The coronary anatomic variation of the left circumflex artery (LCx) is considered as the most common anatomic variation with a separate ostium from the right sinus, and very unusual variation as a proximal branch of right coronary artery (RCA). Case report: We report two cases, the first case is a 64-year-old man with chest pain and with history of hypertension, obesity, dyslipidemia and current smoker, and the second case is a 67-year-old who presented to the emergency department with chest pain and with a past medical history of arterial hypertension and type 2 diabetes mellitus. In the coronarography of the first case is detected an ectopic left circumflex coronary artery from the right coronary sinus with stenotic changes in RCA and LCx. The second case in the coronary angiography revealed an ectopic left circumflex coronary artery from the proximal part of the right coronary artery with stenotic changes in LAD, RCA and LCx. Based on guidelines for revascularization our patients successfully underwent treatment procedures. We present two cases that because of the atherosclerotic coronary artery disease leads to the need of coronarography find out the presence of coronary artery anomalies. Conclusion: During the coronarography we should think about coronary artery anomaly or missing artery knowing that type of these anomalies, considering that may be a contributing factor in the development of the atherosclerosis determines the method of the treatment. PMID:26843740

  8. [Bilateral cerebellar infarction caused by intracranial dissection of the vertebral artery after long periods of "Shiatsu"].

    Science.gov (United States)

    Iwanami, Hisatake; Odaka, Masaaki; Hirata, Koichi

    2007-02-01

    For five years, a 56-year-old woman had undergone "Shiatsu" (a technique that uses fingers and the palm of the hand to apply pressure to particular sections of the body's surface to correct neck stiffness and body imbalances in order to maintain and promote health). She suddenly developed neck pain, dizziness, dysphagia, and speech and gait disturbances during treatment. A neurological examination detected bradylalia and truncal and mild bilateral limb ataxia of the cerebellar type. Diffusion-weighted brain MRI showed multiple hyperintense signal lesions at the bilateral cerebellar hemisphere in the posterior inferior cerebellar artery territory. Three-dimensional computed tomographic angiography (3D-CTA) revealed irregular stenosis of the intracranial right vertebral artery (string sign). Dissection of the intracranial portion of the vertebral artery owing to trauma is rare. Physicians need to be aware of patients who have acute dissecting infarction after long periods of repeated trivial pressure such as "Shiatsu". 3D-CTA is a very useful diagnostic procedure for arterial dissection.

  9. Giant pseudoaneurysm of the extracranial vertebral artery: case report Pseudoaneurisma gigante da artéria vertebral extracraniana: relato de caso

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    Pasquale Gallo

    1996-06-01

    Full Text Available Pseudoaneurysms of the extracranial vertebral artery are extremely rare due to their deep location and the anatomical protection of this artery. They can be caused by cervical traumas (firearm injuries, sports, hyperextension of the neck and iatrogeny. The authors report the case of a patient who developed a giant pseudoaneurysm of the extracranial vertebral artery after surgery for the removal of a tumor of the cerebellopontine angle in which surgical lesion of the artery occurred. Treatment was performed by endovascular approach. Literature is reviewed and comments are made on the physiopathogeny of the lesion and the different forms of treatment.Os pseudoaneurismas da artéria vertebral extracraniana são extremamente raros pela localização profunda e proteção anatômica desta artéria. Podem ser ocasionados por traumas cervicais (ferimentos por armas de fogo, esportes, hiperextensão do pescoço e iãtrogenias. Os autores relatam o caso de um paciente que desenvolveu um pseudoaneurisma gigante da artéria vertebral extracraniana após cirurgia para retirada de tumor de ângulo ponto cerebelar em que ocorreu a lesão cirúrgica desta artéria e cujo tratamento foi endovascular. A literatura é revisada e são feitas considerações sobre a fisiopatogenia da lesão e as várias formas de tratamento.

  10. Congenital Arteriovenous Fistula with Aneurysm Formation of Ulnar Artery Origin

    Directory of Open Access Journals (Sweden)

    Ming-Chi Yung

    2008-12-01

    Full Text Available Naturally formed arteriovenous fistula (AVF causing local vascular aneurysm dilatation in the forearm ulnar artery region is rare and is exceedingly uncommon in any age group. Presented is a case of AVF in the left ulnar artery of a 39-year-old man in whom there was no history of trauma; the deformity had been noted since childhood. The AVF had become tortuous and enlarged in size as the patient aged. As a result, aneurysm dilatation formed on the base of the AVF and that of the ulnar artery origin. Despite normal preoperative Allen test result and normal preoperative finger pressure measurement with ulnar artery occlusion, arterial duplex imaging showed that the radial artery was the dominant artery of the left arm; the AVF was resected and the base of the aneurismal dilatation, which was directly related to the ulnar artery, was repaired for the sake of the natural continuity of ulnar blood flow.

  11. A report of unusual origin of right renal artery

    Directory of Open Access Journals (Sweden)

    Bamac B

    2011-05-01

    Full Text Available During evaluation of abdominal aorta in the serial forensic autopsy cases in the Istanbul Forensic Medicine Institute Morgue, we observed a variation in the origin of the right renal artery in a 49-year-old woman who died of external cause. In this case the right renal artery originated from the superior mesenteric artery. On the left side, the left renal artery arose from the aorta. Clinical significance and embryonic development of this variation have been discussed briefly and a short overview of the literature was given.

  12. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Nadgir, R.N.; Ahmed, T. [University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Loevner, L.A.; Moonis, G.; Slawek, K.; Imbesi, S. [Neuroradiology Section, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States); Chalela, J. [Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, PA 19104, Philadelphia (United States)

    2003-05-01

    Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation. (orig.)

  13. Ultrasonic duplex scanning in atherosclerotic disease of the innominate, subclavian and vertebral arteries. A comparative study with angiography

    NARCIS (Netherlands)

    Eikelboom, B.C.; Ackerstaff, R.G.A.; Hoeneveld, H.; Slowikowski, J.M.; Moll, F.L.; Ludwig, J.W.

    1984-01-01

    Ultrasonic duplex scanning of the vertebral artery has a sensitivity of 0.80 and a specificity of 0.83 for the detection of an obstructive lesion of 50% or more at the site of the ostium. For the subclavian arteries these values are respectively 0.73 and 0.91. For both vessels the test has a very

  14. Ischemic symptoms induced by occlusion of the unilateral vertebral artery with head rotation together with contralateral vertebral artery dissection--case report.

    Science.gov (United States)

    Wakayama, Kouji; Murakami, Mineko; Suzuki, Megumi; Ono, Seiitsu; Shimizu, Natsue

    2005-09-15

    We report a 45-year-old woman whose unilateral vertebral artery (VA) was potentially occluded with head rotation at the C1-C2 level and her ischemic symptoms suddenly appeared because of contralateral VA dissection. She noticed first pain around the posterior part of her neck on the right side, and then dizziness when turning the head to the right side. The dizziness disappeared immediately after her head returned to the natural position. Digital subtraction angiography (DSA) showed a string sign of the right VA. DSA and computed tomography angiography (CTA) showed high grade extrinsic compression of the left VA at the C1-C2 level with head rotation more than 90 degrees to the right. Three-dimensional (3D) CTA also showed clearly kinking of the left VA at the C2 neuroforamina. Her symptoms disappeared completely with conservative therapy, and recanalization of the right VA was also confirmed by 3D-CTA. 3D-CTA was thought to be valuable to diagnose and manage the rotational compression of the artery. VA dissection must be remembered to differentially diagnose the etiology of transient attacks of posterior circulation ischemia due to rotational contralateral VA occlusion.

  15. High-resolution computed tomography evaluation of the bronchial lumen to vertebral body diameter and pulmonary artery to vertebral body diameter ratios in anesthetized ventilated normal cats.

    Science.gov (United States)

    Lee-Fowler, Tekla M; Cole, Robert C; Dillon, A Ray; Tillson, D Michael; Garbarino, Rachel; Barney, Sharron

    2017-10-01

    Objectives Bronchial lumen to pulmonary artery diameter (BA) ratio has been utilized to investigate pulmonary pathology on high-resolution CT images. Diseases affecting both the bronchi and pulmonary arteries render the BA ratio less useful. The purpose of the study was to establish bronchial lumen diameter to vertebral body diameter (BV) and pulmonary artery diameter to vertebral body diameter (AV) ratios in normal cats. Methods Using high-resolution CT images, 16 sets of measurements (sixth thoracic vertebral body [mid-body], each lobar bronchi and companion pulmonary artery diameter) were acquired from young adult female cats and 41 sets from pubertal female cats. Results Young adult and pubertal cat BV ratios were not statistically different from each other in any lung lobe. Significant differences between individual lung lobe BV ratios were noted on combined age group analysis. Caudal lung lobe AV ratios were significantly different between young adult and pubertal cats. All other lung lobe AV ratios were not significantly different. Caudal lung lobe AV ratios were significantly different from all other lung lobes but not from each other in both the young adult and pubertal cats. Conclusions and relevance BV ratio reference intervals determined for individual lung lobes could be applied to both young adult and pubertal cats. Separate AV ratios for individual lung lobes would be required for young adult and pubertal cats. These ratios should allow more accurate evaluation of cats with concurrent bronchial and pulmonary arterial disease.

  16. Spontaneous dissection of the coronary and vertebral arteries post-partum: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cenkowski Marta

    2012-11-01

    Full Text Available Abstract Background Spontaneous coronary and vertebral artery dissections are rare events occurring most commonly in otherwise healthy women during pregnancy or the post-partum period. Case presentation This report describes a 35-year-old female who presented with an acute inferior ST elevation myocardial infarction 7 months post-partum secondary to spontaneous dissection of the left obtuse marginal coronary artery. Despite appropriate medical therapy with dual anti-platelet therapy, the patient presented four weeks later with a spontaneous dissection of the right vertebral artery. Conclusion We review the presentation, diagnosis, and management of spontaneous dissections of the vasculature in the peri-partum period.

  17. Headache and transient visual loss as the only presenting symptoms of vertebral artery dissection: a case report.

    Science.gov (United States)

    Yvon, Camille; Adams, Ashok; McLauchlan, Duncan; Ramsden, Conor

    2016-04-25

    Vertebral artery dissection is an important cause of stroke in the young and diagnosis is often challenging as symptoms are varied and subtle. A 33-year-old, previously healthy, white male office worker was stretching his neck when he developed sudden left-sided visual loss lasting 5 minutes associated with headache. He had no other neurological symptoms or signs. He was investigated with a computed tomography angiogram, which revealed a left vertebral artery dissection with a right posterior cerebral artery vascular occlusion. We describe an atypical case of vertebral artery dissection presenting with sudden transient visual disturbance without neurological signs in an otherwise healthy man. This is a rare but potentially fatal condition that can result in thromboembolic infarction. A high index of suspicion is crucial to make an early diagnosis and avoid devastating neurological outcomes.

  18. Early vertebrate origin and diversification of small transmembrane regulators of cellular ion transport.

    Science.gov (United States)

    Pirkmajer, Sergej; Kirchner, Henriette; Lundell, Leonidas S; Zelenin, Pavel V; Zierath, Juleen R; Makarova, Kira S; Wolf, Yuri I; Chibalin, Alexander V

    2017-07-15

    Small transmembrane proteins such as FXYDs, which interact with Na(+) ,K(+) -ATPase, and the micropeptides that interact with sarco/endoplasmic reticulum Ca(2+) -ATPase play fundamental roles in regulation of ion transport in vertebrates. Uncertain evolutionary origins and phylogenetic relationships among these regulators of ion transport have led to inconsistencies in their classification across vertebrate species, thus hampering comparative studies of their functions. We discovered the first FXYD homologue in sea lamprey, a basal jawless vertebrate, which suggests small transmembrane regulators of ion transport emerged early in the vertebrate lineage. We also identified 13 gene subfamilies of FXYDs and propose a revised, phylogeny-based FXYD classification that is consistent across vertebrate species. These findings provide an improved framework for investigating physiological and pathophysiological functions of small transmembrane regulators of ion transport. Small transmembrane proteins are important for regulation of cellular ion transport. The most prominent among these are members of the FXYD family (FXYD1-12), which regulate Na(+) ,K(+) -ATPase, and phospholamban, sarcolipin, myoregulin and DWORF, which regulate the sarco/endoplasmic reticulum Ca(2+) -ATPase (SERCA). FXYDs and regulators of SERCA are present in fishes, as well as terrestrial vertebrates; however, their evolutionary origins and phylogenetic relationships are obscure, thus hampering comparative physiological studies. Here we discovered that sea lamprey (Petromyzon marinus), a representative of extant jawless vertebrates (Cyclostomata), expresses an FXYD homologue, which strongly suggests that FXYDs predate the emergence of fishes and other jawed vertebrates (Gnathostomata). Using a combination of sequence-based phylogenetic analysis and conservation of local chromosome context, we determined that FXYDs markedly diversified in the lineages leading to cartilaginous fishes (Chondrichthyes) and

  19. Differential diagnosis between traumatic and nontraumatic rupture of the intracranial vertebral artery in medicolegal autopsy.

    Science.gov (United States)

    Ro, Ayako; Kageyama, Norimasa; Takatsu, Akihiro; Fukunaga, Tatsushige

    2009-04-01

    We attempted to establish histopathological identification between traumatic rupture and nontraumatic arterial dissection of the intracranial vertebral artery (IVA) resulting in subarachnoid hemorrhage (SAH). Step-serial observations of ruptured IVAs among four traumatic and 44 nontraumatic SAH patients were investigated. We found that the most specific characteristic for differentiation was the shape of the ruptured adventitia. Extension of the adventitia was clearly observed in nontraumatic cases. In contrast, traumatic cases showed transmural ruptures. Other specific characteristics were also detected. For traumatic cases, small incomplete tears of intima and media were frequently found; they formed oblique tears without adventitial extension. Fragmentized internal elastic lamina was also observed in traumatic cases. In contrast, previous arterial dissections were frequently confirmed in nontraumatic cases. Medial degenerations or defects were detected in all nontraumatic cases. In these cases, the peripheral lesion of the rupture was appeared as intimal tears at recessed vascular wall caused by medial defects. This suggested a relationship between medial lesions and pathogenesis of arterial dissections. These additional features were found in both ruptured and non-ruptured intracranial arteries. We concluded that histopathological investigation is a reliable method for differential diagnosis between traumatic and nontraumatic rupture of the IVA resulting in fatal SAH. These morphological differentiations could be valuable for medicolegal diagnosis.

  20. Endovascular Treatment of Giant P1/P2 Aneurysm by Direct Puncture of the Vertebral Artery

    Science.gov (United States)

    Szajner, M.; Obsza_Ska, K.; Nestorowicz, A.; Szczerbo-Trojanowska, M.; Trojanowski, T.

    2003-01-01

    Summary Vascular access is usually achieved through a femoral arterial puncture using a modified Seldinger technique. However, selective catheterization of the great cerebral vessels by femoral approach fails completely when the vessel is tortuous or atheromatous. In case of posterior vascular circulation aneurysms, transbrachial approach or direct puncture of the vertebral artery (VA) is an alternative. The aneurysms of the posterior cerebral artery (PCA) are reported to be rare. Due to unfavorable anatomic location, the PCA aneurysms are difficult to reach during surgical procedure. Endovascular embolization is at present considered to be more effective and safer treatment of the PCA aneurysms arising from different segments, offering a viable alternative to the surgical approach. We report the case of the giant left PCA aneurysm, located at the junction of P1/P2 segments, successfully treated by parent artery occlusion achieved after the direct puncture of the right VA which was used because both VAs were tortuous, irregular and their ostia were not accessible by femoral approach. According to different authors, parent artery occlusion appears to be safe in the treatment of P2 segment aneurysms, whatever the location of the occlusion. In our case we decided to perform this kind of treatment believing it was the only possible one. PMID:20591315

  1. Vertebral Artery Dissection Associated with Generalized Convulsive Seizures: A Case Report

    Directory of Open Access Journals (Sweden)

    Faisal Mohammad Amin

    2013-07-01

    Full Text Available A 46-year-old male with juvenile myoclonic epilepsy was admitted to the neurological department for convulsive seizures just after lamotrigine was discontinued. On admission he was awake but had a right-sided hemiparesis with Babinski sign and ataxic finger-nose test on the left side. An MR scan showed a left-sided pontine infarction, an infarct in the left cerebellar hemisphere and a right vertebral artery dissection (VAD. The patient was treated with heparin and an oral anticoagulant for 6 months. Recovery of neurologic function was excellent. In patients with symptoms of disturbances of posterior circulation after epileptic seizures, VAD should be considered.

  2. Fetal Isolated Anomalous Origin of Right Pulmonary Artery from Aorta

    Directory of Open Access Journals (Sweden)

    Shi Zeng

    2015-04-01

    Full Text Available The anomalous origin of a branch pulmonary artery from the aorta (AOPA is characterized by the anomalous origin of one of the branch pulmonary arteries (PA from the ascending aorta and a normal origin of the other PA from main PA. AOPA is an extremely rare cardiac malformation. Few studies have reported fetal anomalous origin of PA from aorta with other malformation. We report a case of isolated distal anomalous origin of the right PA from the aorta that was diagnosed by fetal echocardiography at 25 weeks' of gestation. Tracing the course of PA branches is important to make diagnosis.

  3. Fetal Isolated Anomalous Origin of Right Pulmonary Artery from Aorta.

    Science.gov (United States)

    Zeng, Shi; Zhou, Qichang; Zhou, Jiawei; Peng, Qinghai

    2015-04-01

    The anomalous origin of a branch pulmonary artery from the aorta (AOPA) is characterized by the anomalous origin of one of the branch pulmonary arteries (PA) from the ascending aorta and a normal origin of the other PA from main PA. AOPA is an extremely rare cardiac malformation. Few studies have reported fetal anomalous origin of PA from aorta with other malformation. We report a case of isolated distal anomalous origin of the right PA from the aorta that was diagnosed by fetal echocardiography at 25 weeks' of gestation. Tracing the course of PA branches is important to make diagnosis.

  4. High-resolution magnetic resonance imaging reveals hidden etiologies of symptomatic vertebral arterial lesions.

    Science.gov (United States)

    Chung, Jong-Won; Kim, Beom Joon; Choi, Byung Se; Sohn, Chul Ho; Bae, Hee-Joon; Yoon, Byung-Woo; Lee, Seung-Hoon

    2014-02-01

    Symptomatic intracranial vertebral artery (VA) disease has various clinical features and poor neurological outcomes. The disease is believed to result from atherosclerotic stenosis, occlusion, or spontaneous VA dissection. The underlying histopathology of symptomatic intracranial VA disease has only been studied at postmortem, and no in vivo imaging investigation has been conducted despite the increased sophistication of imaging techniques. The authors performed high-resolution magnetic resonance imaging (HR-MRI) of intracranial vertebral arteries in 9 patients, suspected of a VA pathology by magnetic resonance imaging (MRI), magnetic resonance angiography, and digital subtraction angiography. HR-MRI allowed the authors to determine the following: (1) atherosclerotic plaque is composed of a large lipid core with intraplaque hemorrhage and calcification, (2) nonstenotic atherosclerosis exhibits diffuse vessel wall thickening and plaque protruding toward perforating arteries, and (3) spontaneous VA dissection exhibits large intramural hematoma in a false lumen with complete occlusion of the true lumen. In addition, VA hypoplasia was easily differentiated from atherosclerotic stenosis, by direct visualization of a narrow lumen diameter without arterial wall thickening. Furthermore, etiologic diagnoses based on classical MRI, angiography, and digital subtraction angiography were changed in 3 patients after HR-MRI. Additional information on plaque stability, indicating the possibility of unstable plaque, was found in 4 patients. The application of HR-MRI in stroke patients with VA pathologies enabled the authors to determine the underlying pathophysiologies. These findings could be used to improve risk stratification and treatment decision making in symptomatic intracranial VA disease. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  5. Angioplasty and stenting of symptomatic and asymptomatic vertebral artery stenosis: to treat or not to treat.

    Science.gov (United States)

    Parkhutik, V; Lago, A; Tembl, J I; Aparici, F; Vazquez, V; Mainar, E

    2010-02-01

    Comprehensive indications for treatment of symptomatic vertebral stenosis remain unavailable. Even less is known about endovascular treatment of asymptomatic cases. We treated symptomatic and asymptomatic vertebral ostium stenosis with angioplasty and stenting and investigated the long term outcome. Consecutive patients with two different indications were included. Group 1 (G1) had symptomatic >50% stenosis. Group 2 (G2) had asymptomatic >50% stenosis and severe lesions of anterior circulation and were expected to benefit from additional cerebral blood supply. Twenty nine vertebral origin stenoses in 28 patients (75% men, mean age 64 +/- 9 years) were treated. There were 16 G1 and 13 G2 cases. Technical success rate was 100%. Immediate neurological complications rate was 3.4% (one G1 patient with vertebral TIA due to release of emboli). Two further strokes were seen during follow up (32 +/- 24 months): vertebrobasilar stroke in a G2 patient with permeable stent in V1 segment, new ipsilateral V3 occlusion and high-risk cardioembolic source, and carotid stroke in a G1 patient who had had ipsilateral carotid stenting. There were no deaths of any cause. Asymptomatic restenosis was observed in one out of 19 patients from both groups who underwent a follow up angiography. Angioplasty and stenting appears to be technically feasible and safe in asymptomatic and symptomatic vertebral stenosis. More studies are needed in order to clarify its role in primary and secondary prevention of vertebrobasilar stroke. High risk anterior circulation lesions should be taken into account as a possible indication in patients with asymptomatic vertebral stenosis.

  6. Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery

    Science.gov (United States)

    Lee, Seong Ho; Park, Jae Sung

    2016-01-01

    Objective Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases. Methods A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed. Results The 42 patients included in the analysis consisted of 22 females and 20 males, with an average follow-up duration of 76 months (range 24–132 months). Intraoperative investigation revealed that an artery other than the VA was responsible for the neurovascular compression in all cases : posterior inferior cerebellar artery (PICA) in 23 patients (54.7%) and anterior inferior cerebellar artery (AICA) in 11 patients (26.2%). All patients became symptom-free after MVD. Neither recurrence nor postoperative neurological deficit was noted during the 2-year follow-up, except in one patient who developed permanent deafness. Cerebrospinal fluid (CSF) leak occurred in three patients, and one required dural repair. Conclusion Transposition of the VA using a bioglue-coated Teflon sling is a safe and effective surgical technique for HFS involving the VA. A future prospective study to compare clinical outcomes between groups with and without use of this novel technique is required. PMID:27651870

  7. Superior Mesenteric Artery Syndrome due to a Vertebral Hemangioma and Postpartum Osteoporosis following Treatment

    Directory of Open Access Journals (Sweden)

    Mehmet Elmadag

    2015-01-01

    Full Text Available In pregnancy, advanced vertebral hemangiomas may be seen, and these require treatment. The case reported here is of a 35-year-old female in the 32nd week of pregnancy who was admitted to the orthopaedics clinic with a history of backache and difficulty walking. A burst fracture of L1 associated with a vertebral hemangioma was identified with an L3 compression fracture secondary to osteoporosis. The local kyphosis angle between T12 and L2 was 27°. Kyphotic deformity was corrected and postoperatively, the measured T12–L2 local kyphotic angle was 9°. Twelve hours postoperatively, oral nutrition was allowed, but she developed nausea and vomiting and twenty-four hours postoperatively, an electrolyte imbalance developed. Postoperatively, the patient was diagnosed with superior mesenteric artery syndrome. To the best of our knowledge, this is the first reported case of superior mesenteric artery syndrome, which occurred following the correction of a kyphotic deformity that had developed secondary to an advanced hemangioma in pregnancy.

  8. Aberrant overian artery originating from the Ilolumbar artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Eun; Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2016-05-15

    Here, we report a case of a 30-year-old woman who presented with primary postpartum hemorrhage due to uterine atony. She received uterine artery embolization (UAE). During left internal iliac arteriography, an aberrant left ovarian artery originating from the left iliolumbar artery was visualized. The aberrant left ovarian artery was connected to the left uterine artery via prominent collateral vessels. It supplied a significant amount of blood to the fundus of the uterus. Bilateral hypertrophied uterine arteries were embolized very carefully so that the embolic material did not reflux into the aberrant left ovarian artery. After the procedure, her vaginal bleeding was successfully controlled. Accurate understanding of anatomical variations of the ovarian artery is essential to avoid failure in controlling postpartum hemorrhage with UAE.

  9. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography

    Directory of Open Access Journals (Sweden)

    Guray Oncel

    2013-01-01

    Full Text Available Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT and magnetic resonance imaging (MRI has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT. The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery.

  10. Intramural hematoma detection by susceptibility-weighted imaging in intracranial vertebral artery dissection.

    Science.gov (United States)

    Kim, Tae-Won; Choi, Hyun Seok; Koo, Jaseong; Jung, So Lyung; Ahn, Kook-Jin; Kim, Bum-Soo; Shin, Yong Sam; Lee, Kwang Soo

    2013-01-01

    The radiologic diagnosis of vertebral artery dissection (VAD) depends on characteristic intraluminal findings on angiography and intramural hematoma or a double-lumen sign on high-resolution vessel wall imaging. We aimed to evaluate the accuracy of intramural hematoma sign on susceptibility-weighted imaging (SWI) in VAD. We retrospectively analyzed SWI, phase map images and brain computed tomography (CT) of the consecutive patients who suffered an ischemic stroke in the vertebral artery territory from August 2010 to July 2012. We divided the patients into 2 groups: the VAD group and the nondissection group. VAD was diagnosed by conventional catheter angiographic findings (aneurysmal dilatation, pearl-and-string or tapered steno-occlusion) and pathognomonic findings such as intramural hematoma or a double-lumen sign on the source images of TOF-MRA, high-resolution T1-weighted MRI or high-resolution T2-weighted MRI. Intramural hematoma sign was considered positive if the patient had an eccentric or concentric hypointense signal lesion in the vertebral artery on SWI, a corresponding hyperintense signal on phase map and no evidence of calcification on the brain CT, suggesting blood products other than calcification. Two experienced neuroradiologists blinded to clinical information and angiographic findings were asked to judge for the presence of intramural hematoma sign on SWI. The accuracy of intramural hematoma sign on SWI was evaluated. Phase value, demographic and clinical data were compared between the VAD and the nondissection groups. Thirty-nine patients were included: 10 in the VAD group and 29 in the non-dissection group. Among the VAD group cases, intramural hematoma sign on SWI was positive in 9 of the 10 VAD cases and in 1 out of the 29 cases in the nondissection group. The intramural hematoma sign on SWI was significantly associated with VAD (p radian vs. -0.42 radian, p < 0.001). The intramural hematoma sign on SWI was significantly associated with VAD

  11. Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Quanli; Yao, Qiong; Hu, Xihong [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China)

    2016-09-15

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40-97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66-100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography. (orig.)

  12. Treatment of Ruptured Vertebral Artery Dissecting Aneurysms Distal to the Posterior Inferior Cerebellar Artery: Stenting or Trapping?

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Yi-Bin, E-mail: fangyibin@163.com; Zhao, Kai-Jun, E-mail: zkjwcfzwh@163.com; Wu, Yi-Na, E-mail: wuyina0923@163.com; Zhou, Yu, E-mail: yzhou-2011@126.com; Li, Qiang, E-mail: lqeimm@126.com; Yang, Peng-Fei, E-mail: 15921196312@163.com; Huang, Qing-Hai, E-mail: ocinhqh@163.com; Zhao, Wen-Yuan, E-mail: doczhaowy@163.com; Xu, Yi, E-mail: xuyichyy@163.com; Liu, Jian-Min, E-mail: chstroke@163.com [Second Military Medical University, Department of Neurosurgery, Changhai Hospital (China)

    2015-06-15

    PurposeThe treatment of ruptured vertebral artery dissecting aneurysms (VADAs) continues to be controversial. Our goal was to evaluate the safety, efficacy, and long-term outcomes of internal trapping and stent-assisted coiling (SAC) for ruptured VADAs distal to the posterior inferior cerebellar artery (supra-PICA VADAs), which is the most common subset.MethodsA retrospective review was conducted of 39 consecutive ruptured supra-PICA VADAs treated with internal trapping (n = 20) or with SAC (n = 19) at our institution. The clinical and angiographic data were retrospectively compared.ResultsThe immediate total occlusion rate of the VADAs was 80 % in the trapping group, which improved to 88.9 % at the follow-ups (45 months on average). Unwanted occlusions of the posterior inferior cerebellar artery (PICA) were detected in three trapped cases. Incomplete obliteration of the VADA or unwanted occlusions of the PICA were detected primarily in the VADAs closest to the PICA. In the stenting group, the immediate total occlusion rate was 47.4 %, which improved to 100 % at the follow-ups (39 months on average). The immediate total occlusion rate of the VADAs was higher in the trapping group (p < 0.05), but the later total occlusion was slightly higher in the stenting group (p > 0.05).ConclusionsOur preliminary results showed that internal trapping and stent-assisted coiling are both technically feasible for treating ruptured supra-PICA VADAs. Although not statistically significant, procedural related complications occurred more frequently in the trapping group. When the VADAs are close to the PICA, we suggest that the lesions should be treated using SAC.

  13. A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy

    OpenAIRE

    Ke, Jiang-qiong; Yin, Bo; Fu, Fang-Wang; Shao, Sheng-Min; Lin, Yan; Dong, Qi-Qiang; Wang, Xiao-Tong; Zheng, Guo-Qing

    2016-01-01

    Abstract Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy. A 36-year-old right-handed man...

  14. Evolutionary origin of peptidoglycan recognition proteins in vertebrate innate immune system

    Directory of Open Access Journals (Sweden)

    Tsujino Fumi

    2011-03-01

    Full Text Available Abstract Background Innate immunity is the ancient defense system of multicellular organisms against microbial infection. The basis of this first line of defense resides in the recognition of unique motifs conserved in microorganisms, and absent in the host. Peptidoglycans, structural components of bacterial cell walls, are recognized by Peptidoglycan Recognition Proteins (PGRPs. PGRPs are present in both vertebrates and invertebrates. Although some evidence for similarities and differences in function and structure between them has been found, their evolutionary history and phylogenetic relationship have remained unclear. Such studies have been severely hampered by the great extent of sequence divergence among vertebrate and invertebrate PGRPs. Here we investigate the birth and death processes of PGRPs to elucidate their origin and diversity. Results We found that (i four rounds of gene duplication and a single domain duplication have generated the major variety of present vertebrate PGRPs, while in invertebrates more than ten times the number of duplications are required to explain the repertoire of present PGRPs, and (ii the death of genes in vertebrates appears to be almost null whereas in invertebrates it is frequent. Conclusion These results suggest that the emergence of new PGRP genes may have an impact on the availability of the repertoire and its function against pathogens. These striking differences in PGRP evolution of vertebrates and invertebrates should reflect the differences in the role of their innate immunity. Insights on the origin of PGRP genes will pave the way to understand the evolution of the interaction between host and pathogens and to lead to the development of new treatments for immune diseases that involve proteins related to the recognition of self and non-self.

  15. The Lamprey: A jawless vertebrate model system for examining origin of the neural crest and other vertebrate traits

    Science.gov (United States)

    Green, Stephen A.; Bronner, Marianne E.

    2014-01-01

    Summary Lampreys are a group of jawless fishes that serve as an important point of comparison for studies of vertebrate evolution. Lampreys and hagfishes are agnathan fishes, the cyclostomes, which sit at a crucial phylogenetic position as the only living sister group of the jawed vertebrates. Comparisons between cyclostomes and jawed vertebrates can help identify shared derived (i.e. synapomorphic) traits that might have been inherited from ancestral early vertebrates, if unlikely to have arisen convergently by chance. One example of a uniquely vertebrate trait is the neural crest, an embryonic tissue that produces many cell types crucial to vertebrate features, such as the craniofacial skeleton, pigmentation of the skin, and much of the peripheral nervous system (Gans and Northcutt, 1983). Invertebrate chordates arguably lack unambiguous neural crest homologs, yet have cells with some similarities, making comparisons with lampreys and jawed vertebrates essential for inferring characteristics of development in early vertebrates, and how they may have evolved from nonvertebrate chordates. Here we review recent research on cyclostome neural crest development, including research on lamprey gene regulatory networks and differentiated neural crest fates. PMID:24560767

  16. Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Lyudmila Andreevna Kalashnikova

    2013-01-01

    Full Text Available The paper gives the data available in the literature and the author’s results of an examination of almost 140 patients with dissection of the internal carotid and vertebral arteries (ICA and VA. Dissection is blood penetration through an intimal tear from the lumen of an artery into its wall to develop intramural hematoma (IMH. The cause of dissection is the weakness of the arterial wall presumably due to mitochondrial cytopathy. IMH narrows/occludes the arterial lumen or is a source of arterioarterial embolism, which in turn leads to ischemic stroke. Stroke as a result of dissection generally develops in young patients, who are not prone to traditional vascular risk factors, frequently after the influence of provocative factors (mild head/neck injury, head jerks, physical strain, contraceptives, etc.. The characteristics of stroke are head/neck pain on the side of dissection that appears a few days prior to stroke or simultaneously with the latter; quite often a good recovery of impaired functions; and low recurrence rates. Another major manifestation, isolated cervicocephalic pain, is encountered in PA dissection more frequently (in almost a third of cases and in ICA dissection less frequently (about 5%. Magnetic resonance (MR angiography and fat-saturated T1-weighted MR imaging play a leading role in the verification of dissection. Dissection should be treated with anticoagulants/antiaggregants in its acute phase, as well as with trophic drugs, primarily actovegin, in both acute and chronic phases.

  17. The use of CT-angiography for monitoring thrombus formation after balloon occlusion of a dissecting vertebral artery pseudoaneurysm

    NARCIS (Netherlands)

    Verstegen, Marco J. T.; Hulsmans, Frans-Jan H.; Majoie, Charles B. L. M.; Bouma, Gerrit J.

    2002-01-01

    We present a 49-year-old man with a subarachnoid haemorrhage from a dissecting vertebral artery (VA) pseudoaneurysm treated with a proximal balloon occlusion. The clinical course was complicated by the sudden appearance of a lateral medullary syndrome (Wallenberg), which completely resolved after

  18. Giant aneurysm of the vertebral artery in neurofibromatosis type 1: report of a case and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, K.T.; Hosten, N.; Liebig, T.; Felix, R. [Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Humboldt-Universitaet zu Berlin, Augustenburger Platz 1, D-13353 Berlin (Germany); Schwarz, K. [Neurochirurgische Klinik, Virchow-Klinikum Humboldt-Universitaet zu Berlin, Berlin (Germany)

    1998-04-01

    Cranial and cervical vessels are rarely involved in neurofibromatosis type 1. Stenoses and occlusion due to intimal or medial dysplasia are most often seen, followed by aneurysms. We report a rare asymptomatic giant aneurysm of the vertebral artery in a 59-year old man with von Recklinghausen`s neurofibromatosis and review the literature. (orig.) With 3 figs., 1 tab., 22 refs.

  19. Evaluation of the effects of sildenafil citrate (viagra) on vertebral artery blood flow in patients with vertebro-basilar insufficiency.

    Science.gov (United States)

    Bozgeyik, Zulkif; Berilgen, Sait; Ozdemir, Huseyin; Tekatas, Aslan; Ogur, Erkin

    2008-01-01

    To investigate the effects of sildenafil citrate (Viagra) on the vertebral artery blood flow of patients with vertebro-basilar insufficiency (VBI) using color duplex sonography (CDS). The study included 21 patients with VBI (aged 31-76; mean 61.0 +/- 10.5 yrs). We administered a 50 mg oral dose of sildenafil citrate to all patients. Next, we measured the peak systolic velocity (Vmax), end diastolic velocity (Vmin), resistive index (RI), pulsatility index (PI), diameter, area, and flow volume (FV) of vertebral arteries using CDS before the administration of sildenafil citrate; 45 minutes after, and 75 minutes after administration. Statistical testing was performed using SPSS for windows version 11.0. The statistical test used to determine the outcome of the analysis was the repeated measures analysis of variance (ANOVA) test. Compared to the baseline values, the vertebral artery diameter, area, and FV increased significantly following the administration of sildenafil citrate. The diameter, area and FV increased from 3.39 mm at 45 minutes to 3.64 mm at 75 minutes, 9.43 cm(2) to 10.80 cm(2) at 45 minutes and 10.81 cm(2) at 75 minutes, as well as from 0.07 L/min at baseline to 0.09 L/min at 45 minutes and unchanged at 75 minutes, respectively. Sildenafil citrate elicited a significant effect on vertebral artery diameter, area and FVs.

  20. Evaluation of the Effects of Sildenafil Citrate (Viagra) on Vertebral Artery Blood Flow in Patients with Vertebro-Basilar Insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Bozgeyik, Zulkif; Berilgen, Sait; Ozdemir, Huseyin; Ogur, Erkin [Firat University School of Medicine, Elazig(Turkmenistan); Tekatas, Aslan [Elazig Government Hospital, Elazig (Turkmenistan)

    2008-12-15

    To investigate the effects of sildenafil citrate (Viagra) on the vertebral artery blood flow of patients with vertebro-basilar insufficiency (VBI) using color duplex sonography (CDS). The study included 21 patients with VBI (aged 31-76; mean 61.0 +- 10.5 yrs). We administered a 50 mg oral dose of sildenafil citrate to all patients. Next, we measured the peak systolic velocity (Vmax), end diastolic velocity (Vmin), resistive index (RI), pulsatility index (PI), diameter, area, and flow volume (FV) of vertebral arteries using CDS before the administration of sildenafil citrate; 45 minutes after, and 75 minutes after administration. Statistical testing was performed using SPSS for windows version 11.0. The statistical test used to determine the outcome of the analysis was the repeated measures analysis of variance (ANOVA) test. Compared to the baseline values, the vertebral artery diameter, area, and FV increased significantly following the administration of sildenafil citrate. The diameter, area and FV increased from 3.39 mm at 45 minutes to 3.64 mm at 75 minutes, 9.43 cm{sup 2} to 10.80 cm{sup 2} at 45 minutes and 10.81 cm{sup 2} at 75 minutes, as well as from 0.07 L/min at baseline to 0.09 L/min at 45 minutes and unchanged at 75 minutes, respectively. Sildenafil citrate elicited a significant effect on vertebral artery diameter, area and FVs

  1. Preliminary report: biomechanics of vertebral artery segments C1-C6 during cervical spinal manipulation.

    Science.gov (United States)

    Wuest, Sarah; Symons, Bruce; Leonard, Timothy; Herzog, Walter

    2010-05-01

    The purpose of this study was to measure strains in the human vertebral artery (VA) within the cervical transverse foramina and report the first results on the mechanical loading of segments of the VA during spinal manipulation of the cervical spine. Eight piezoelectric ultrasound crystals of 0.5-mm diameter were sutured into the lumen of the left and right VA of one cadaver. Four hundred-nanosecond ultrasound pulses were sent between the crystals to measure the instantaneous lengths of the VA segments (total segments n = 14) at a frequency of 200 Hz. Vertebral artery engineering strains were then calculated from the instantaneous lengths during cervical spinal range of motion testing, chiropractic cervical spinal manipulation adjustments, and vertebrobasilar insufficiency testing. The results of this study suggest complex and nonintuitive strain patterns of the VA within the cervical transverse foramina. Consistent (for 2 chiropractors) and repeatable (for 3 repeat measurements for each chiropractor) elongation and shortening of adjacent VA segments were observed simultaneously and could not be explained with a simple model of neck movement. We hypothesized that they were caused by variations in the location and stiffness of the VA fascial attachments to the vertebral foramina and by coupled movements of the cervical vertebrae. However, in agreement with previous work on VA strains proximal and distal to the cervical transverse foramina, strains for cervical spinal manipulations were consistently lower than those obtained for cervical rotation. Although general conclusions should not be drawn from these preliminary results, the findings of this study suggest that textbook mechanics of the VA may not hold, that VA strains may not be predictable from neck movements alone, and that fascial connections within the transverse foramina and coupled vertebra movements may play a crucial role in VA mechanics during neck manipulation. Furthermore, the engineering strains

  2. Transcranial color-coded sonography of vertebral artery for diagnosis of right-to-left shunts.

    Science.gov (United States)

    Komatsu, Teppei; Terasawa, Yuka; Arai, Ayumi; Sakuta, Kenichi; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2017-05-15

    It is unknown whether contrast transcranial color-coded sonography of vertebral artery monitoring via the foramen magnum window (cTCCS-VA) is useful to detect right-to-left shunt (RLS). We investigated whether cTCCS-VA can be proposed as an alternative to middle cerebral artery monitoring via the temporal bone window (cTCCS-MCA) for RLS detection, as compared with contrast transesophageal echocardiography (cTEE). We evaluated 112 patients with ischemic stroke or transient ischemic attack. We compared the sufficiency of both acoustic windows in each age tertile. Then, we analyzed the accuracy of cTCCS in diagnosing an RLS for a patent foramen ovale (PFO) detected by cTEE. In the higher-age tertile, the foramen magnum window was significantly more sufficient than the temporal bone window (100% vs. 71%, pplay an important role in detecting an RLS, especially in elderly stroke patients having large PFOs. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Anomalous Origin of the Subclavian Artery Associated with ...

    African Journals Online (AJOL)

    Anomalous origin of the right subclavian artery is a well- known anomaly; in most instances it is not responsible for symptoms and is an incidental finding at angiography, surgery or autopsy.'" If symptoms of tracheal compres- sion occur, surgical relief of the abnormal vascular ring is necessary. It is the purpose of this report ...

  4. Morphological characteristics of origin of superior arterial mesenteric trunk

    Directory of Open Access Journals (Sweden)

    Niscoveanu C.

    2016-08-01

    Full Text Available Our study was conducted on a total of 46 CT angiographies, performed on a GE LightSpeed VCT 64-slice CT installation. Benchmarks were followed in relation to the gender of the person examined. The origin of the superior mesenteric artery relative to the spine we found it in a range between T12 vertebra and L1-L2 intervertebral disc. The T12 vertebra origin was localized in 2 cases (4.35% of cases, both in women. Superior mesenteric artery originated at the level of L1 in 78.26% (90.91% of male cases and in 66.67% of women cases. In 8 cases (17.39% of cases the origin of the superior mesenteric artery was located at the L1-L2 intervertebral disc. Endolumenal vertical diameter of the superior mesenteric artery orifice we found it in the range of 5.6 to 10.9 mm (6.9 to 10.9 mm in men, and 5.6 to 8.6 mm in women. Horizontal diameter sizes ranged from 4.9 to 9.7 mm, having 6.4 to 9.7 mm in men and 4.9 to 8.3 mm in women. Vertical diameter in males was higher in 59.09% of cases, with differences between 0.1 to 2.4 mm, and in 40.91% of cases the horizontal diameter was larger with differences between 0,1-2.1 mm. Vertical diameter in women was higher in 50% of cases, with differences of 0.1-2.0 mm and the other 50% the horizontal diameter was larger, with differences ranging from 0.1 to 2.2 mm. The angle that the superior mesenteric artery makes it with the aortic wall we found between 16,60-120,8o, males having values between 24,8-120,8o, and in women 16,7-120,8o. The distance between the origin of the superior mesenteric artery and celiac trunk we found it between 5.0 and 16.5 mm, males having 5.0 to 12.1 mm and women 6.9 -16.5 mm. The distance between the origin of the superior mesenteric artery and right renal artery was ranging between 6.2 to 23.5 mm, in males being 6.5 to 19.1 mm and in women from 6.2 to 23 5 mm. The distance between the origin of the superior mesenteric artery and left renal artery we found between 5.7 to 23.5 mm, in males being

  5. Mechanism and patterns of cervical spine fractures-dislocations in vertebral artery injury

    Directory of Open Access Journals (Sweden)

    Pankaj Gupta

    2012-01-01

    Full Text Available Purpose: To identify the fracture patterns and mechanism of injury, based on subaxial cervical spine injury classification system (SLIC, on non-contrast computed tomography (NCCT of cervical spine predictive of vertebral artery injury (VAI. Patients and Methods: We retrospectively analyzed cervical spine magnetic resonance imaging (MRI of 320 patients who were admitted with cervical spine injury in our level I regional trauma center over a period of two years (April 2010 to April 2012. Diagnosis of VAI was based on hyperintensity replacing the flow void on a T2-weighted axial image. NCCT images of the selected 43 patients with MRI diagnosis of VAI were then assessed for the pattern of injury. The cervical spinal injuries were classified into those involving the C1 and C2 and subaxial spine. For the latter, SLIC was used. Results: A total of 47 VAI were analyzed in 43 patients. Only one patient with VAI on MRI had no detectable abnormality on NCCT. C1 and C2 injuries were found in one and six patients respectively. In subaxial injuries, the most common mechanism of injury was distraction (37.5% with facet dislocation with or without fracture representing the most common pattern of injury (55%. C5 was the single most common affected vertebral level. Extension to foramen transversarium was present in 20 (42.5% cases. Conclusion: CT represents a robust screening tool for patients with VAI. VAI should be suspected in patients with facet dislocation with or without fractures, foramina transversarium fractures and C1-C3 fractures, especially type III odontoid fractures and distraction mechanism of injury.

  6. A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy.

    Science.gov (United States)

    Ke, Jiang-Qiong; Yin, Bo; Fu, Fang-Wang; Shao, Sheng-Min; Lin, Yan; Dong, Qi-Qiang; Wang, Xiao-Tong; Zheng, Guo-Qing

    2016-02-01

    Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy.A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, although the patient remained conscious, he could not speak but could communicate with the surrounding by blinking or moving his eyes, and turned to complete quadriplegia, complete facial and bulbar palsy, dyspnea at 4 hours after admission. He was diagnosed with LIS. Then, the patient was received cervical and brain computed tomography angiography that showed bilateral VAD. Aortocranial digital subtraction angiography showed vertebrobasilar thrombosis, blocking left vertebral artery, and stenosis of right vertebral artery. The patient was treated by using emergency arterial embolectomy and followed by antiplatelet therapy and supportive therapy in the intensive care unit and a general ward. Twenty-seven days later, the patient's physical function gradually improved and discharged but still left neurological deficit with muscle strength grade 3/5 and hyperreflexia of limbs.Our findings suggested that CSM might have potential severe side-effect like LIS due to bilaterial VAD, and arterial embolectomy is an important treatment choice. The practitioner must be aware of this complication and should give the patients informed consent to CSM, although not all stroke cases temporally related to SCM have pre-existing craniocervical artery dissection.

  7. [Hypoalgesia and hypothermesthesia in a lower extremity due to compression of the medulla oblongata by an elongated vertebral artery].

    Science.gov (United States)

    Iwasaki, Yasushi; Nakamura, Tomohiko; Hamada, Kensuke

    2004-03-01

    We describe the case of a 54-year-old man who presented with hypoalgesia and hypothermesthesia (pain and thermal numbness) in the left lower extremity. The patient first noticed a warm sensation in his left leg. By the time he first visited our neurological unit, the symptoms had been present for several weeks. His blood pressure was normal. Cranial nerve function and other neurological findings were normal except for hypoalgesia and hypothermesthesia in the left leg. Position and vibration senses were intact. Autonomic dysfunction was not found. Nerve conduction velocity and somatosensory evoked potentials were normal. Cranial MRI, MRA and 3D-CT showed an elongated and curved right vertebral artery that was normal in diameter but compressed to the lateral medullary zone. The artery was thought to compress the lateral spinothalamic tract. Cervical, thoracic and lumbo-sacral MRI findings were all normal. We believe that the patient's symptoms were provoked by the abnormal compression of the vertebral artery. The symptoms improved gradually within 2 month without operation therapy, but some hypoalgesia and hypothermesthesia are still present in the left leg. Although several reports have described compression of the medulla oblongata by a vertebral artery, to the best of our knowledge, there have been no reports of hypoalgesia and hypothermesthesia due to vascular compression of the medulla oblongata.

  8. [Case of cerebellar and spinal cord infarction presenting with acute brachial diplegia due to right vertebral artery occlusion].

    Science.gov (United States)

    Fujii, Takayuki; Santa, Yo; Akutagawa, Noriko; Nagano, Sukehisa; Yoshimura, Takeo

    2012-01-01

    A 73-year-old man was admitted for evaluation of sudden onset of dizziness, bilateral shoulder pain, and brachial diplegia. Neurological examination revealed severe bilateral weakness of the triceps brachii, wrist flexor, and wrist extensor muscles. There was no paresis of the lower limbs. His gait was ataxic. Pinprick and temperature sensations were diminished at the bilateral C6-C8 dermatomes. Vibration and position senses were intact. An MRI of the head revealed a right cerebellar infarction and occlusion of the right vertebral artery. An MRI of the cervical spine on T₂ weighted imaging (T₂WI) showed cord compression at the C3/4-C5/6 level secondary to spondylotic degeneration without any intramedullary signal changes of the cord. On the following day, however, high-signal lesions on T₂WI appeared in the C5-C6 spinal cord, suggesting cord infarction. Unilateral vertebral artery occlusion does not usually result in cervical cord infarction because of anastomosis of arteries. Because of the long-term mechanical compression in our case, it was likely that cervical cord ischemia was present before the onset of symptoms. On the basis of chronic cord compression, our case suggests that occlusion of a unilateral vertebral artery could cause cervical cord infarction.

  9. Dissection of the V4 segment of the vertebral artery: clinicoradiologic manifestations and endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Woong; Seo, Jeong Jin [Chonnam National University Medical School, Department of Radiology, Chonnam National University Hospital, 501-757Dong-gu, Gwangju (Korea); Kim, Tae Sun [Chonnam National University Medical School, Department of Neurosurgery, Chonnam National University Hospital, Dong-gu, Gwangju (Korea); Do, Huy M.; Jayaraman, Mahesh V.; Marks, Michael P. [Stanford University Medical Center, Department of Radiology, Stanford, California (United States)

    2007-04-15

    Intracranial vertebral artery (VA) dissection has three clinical presentations: ischemia, hemorrhage, and mass effect. Imaging findings of intracranial VA dissections vary according to clinical presentation. Irregular stenosis or occlusion of the VA is the most common finding in patients with posterior fossa infarction, whereas a dissecting aneurysm is the main feature in those with acute subarachnoid hemorrhage. A chronic, giant, dissecting aneurysm can cause mass effect on the brain stem or cranial nerves, as well as distal embolism. Magnetic resonance imaging is useful for detection of intramural hematomas and intimal flaps, both of which are diagnostic of VA dissection. Multidetector computed tomography angiography is increasingly used for diagnosis of VA dissection. Catheter angiography is still beneficial for evaluation of precise endoluminal morphology of the dissection before surgical or endovascular intervention. Endovascular treatment is now considered a major therapeutic option for patients with a ruptured dissecting aneurysm or a chronic dissecting aneurysm. Anticoagulation therapy is currently considered the initial treatment of choice in patients with posterior circulation ischemic symptoms. Endovascular treatment, such as stent-assisted angioplasty or coil occlusion at the dissection site, can be performed in selected patients with posterior fossa ischemic symptoms. (orig.)

  10. Is coronary artery calcification associated with vertebral bone density in nondialyzed chronic kidney disease patients?

    Science.gov (United States)

    Filgueira, Agostinho; Carvalho, Aluizio Barbosa; Tomiyama, Cristiane; Higa, Andrea; Rochitte, Carlos E; Santos, Raul D; Canziani, Maria Eugênia F

    2011-06-01

    Low bone mineral density and coronary artery calcification (CAC) are highly prevalent among chronic kidney disease (CKD) patients, and both conditions are strongly associated with higher mortality. The study presented here aimed to investigate whether reduced vertebral bone density (VBD) was associated with the presence of CAC in the earlier stages of CKD. Seventy-two nondialyzed CKD patients (age 52 ± 11.7 years, 70% male, 42% diabetics, creatinine clearance 40.4 ± 18.2 ml/min per 1.73 m(2)) were studied. VBD and CAC were quantified by computed tomography. CAC > 10 Agatston units (AU) was observed in 50% of the patients (median 120 AU [interquartile range 32 to 584 AU]), and a calcification score ≥ 400 AU was found in 19% (736 [527 to 1012] AU). VBD (190 ± 52 Hounsfield units) correlated inversely with age (r = -0.41, P < 0.001) and calcium score (r = -0.31, P = 0.01), and no correlation was found with gender, creatinine clearance, proteinuria, lipid profile, mineral parameters, body mass index, and diabetes. Patients in the lowest tertile of VBD had expressively increased calcium score in comparison to the middle and highest tertile groups. In the multiple logistic regression analysis adjusting for confounding variables, low VBD was independently associated with the presence of CAC. Low VBD was associated with CAC in nondialyzed CKD patients. The authors suggest that low VBD might constitute another nontraditional risk factor for cardiovascular disease in CKD.

  11. Sensing disease and danger: A survey of vertebrate PRRs and their origins

    Science.gov (United States)

    Hansen, John D.; Vojtech, Lucia N.; Laing, Kerry J.

    2011-01-01

    A key facet of the innate immune response lays in its ability to recognize and respond to invading microorganisms and cellular disturbances. Through the use of germ-line encoded PRRs, the innate immune system is capable of detecting invariant pathogen motifs termed pathogen-associated molecular patterns (PAMPS) that are distinct from host encoded proteins or products released from dying cells, which are known as damage-associated molecular patterns (DAMPs). PAMPs and DAMPs include both protein and nucleic acids for the detection and response to pathogens and metabolic "danger" signals. This is by far one of the most active areas of research as recent studies have shown retinoic acid inducible gene 1 (RIG1)-like receptors (RLRs), the nucleotide-binding domain, leucine-rich repeat containing proteins (NLRs) and Toll-like receptors (TLRs) and the recently described AIM-like receptors (ALRs) are responsible for initiating interferon production or the assembly and activation of the inflammasome, ultimately resulting in the release of bioactive IL-1 family members. Overall, the vertebrate PRR recognition machinery consists of seven domains (e.g., Death, NACHT, CARD, TIR, LRR, PYD, helicase), most of which can be traced to the very origins of the deuterostomes. This review is intended to provide an overview of the basic components that are used by vertebrates to detect and respond to pathogens, with an emphasis on these receptors in fish as well as a brief note on their likely origins.

  12. Reconstructive endovascular treatment of vertebral artery dissecting aneurysms with the Low-profile Visualized Intraluminal Support (LVIS) device

    OpenAIRE

    Wang, Chuan-Chuan; Fang, Yi-Bin; Zhang, Ping; ZHU, XUAN; Hong, Bo; Xu, Yi; Liu, Jian-Min; Huang, Qing-Hai

    2017-01-01

    Introduction The Low-profile Visualized Intraluminal Support (LVIS) device is a new generation of self-expanding braided stent recently introduced in China for stent assisted coiling of intracranial aneurysms. The aim of our study is to evaluate the feasibility, safety, and efficacy of the LVIS device in reconstructive treatment of vertebral artery dissecting aneurysms (VADAs). Methods We retrospectively reviewed the neurointerventional database of our institution from June 2014 to May 2016. ...

  13. Arthroplasty-CervicalP001 - Double Crush Syndrome of the Vertebral Artery Loop and Foraminal Stenosis Causing Monoparesis

    OpenAIRE

    Rho, Young Joon; Choi, Hoon; Kurpad, Shekar; Soliman, Hesham; Heo, Dong Hwa; Park, Choon Keun; Lee, Jun Ho; Lee, Jung Hwan; Benitez, Hugo Alberto Santos; Rivera, Miguel Angel Fuentes; Moga, Amado Gonzalez; Hernandez, Gabriel Huerta; Urbina, Mizraim Castillo; Ozkunt, Okan; Sariyilmaz, Kerim

    2017-01-01

    Introduction: To report a case of monoparesis caused by a vertebral artery (VA) anomaly and foraminal stenosis treated with microvascular decompression by the posterior approach. Material and Methods: A 51-year-old man was referred because of a 4-year history of progressive left shoulder pain refractory to other forms of treatment and a 7-month history of arm weakness. Clinical and radiologic evaluation showed an abnormally tortuous loop of left C5-6 cervical foramina with foraminal stenosis ...

  14. Concomitant duplications of opioid peptide and receptor genes before the origin of jawed vertebrates.

    Directory of Open Access Journals (Sweden)

    Görel Sundström

    Full Text Available BACKGROUND: The opioid system is involved in reward and pain mechanisms and consists in mammals of four receptors and several peptides. The peptides are derived from four prepropeptide genes, PENK, PDYN, PNOC and POMC, encoding enkephalins, dynorphins, orphanin/nociceptin and beta-endorphin, respectively. Previously we have described how two rounds of genome doubling (2R before the origin of jawed vertebrates formed the receptor family. METHODOLOGY/PRINCIPAL FINDINGS: Opioid peptide gene family members were investigated using a combination of sequence-based phylogeny and chromosomal locations of the peptide genes in various vertebrates. Several adjacent gene families were investigated similarly. The results show that the ancestral peptide gene gave rise to two additional copies in the genome doublings. The fourth member was generated by a local gene duplication, as the genes encoding POMC and PNOC are located on the same chromosome in the chicken genome and all three teleost genomes that we have studied. A translocation has disrupted this synteny in mammals. The PDYN gene seems to have been lost in chicken, but not in zebra finch. Duplicates of some peptide genes have arisen in the teleost fishes. Within the prepropeptide precursors, peptides have been lost or gained in different lineages. CONCLUSIONS/SIGNIFICANCE: The ancestral peptide and receptor genes were located on the same chromosome and were thus duplicated concomitantly. However, subsequently genetic linkage has been lost. In conclusion, the system of opioid peptides and receptors was largely formed by the genome doublings that took place early in vertebrate evolution.

  15. Evolutionary origins of C-terminal (GPPn 3-hydroxyproline formation in vertebrate tendon collagen.

    Directory of Open Access Journals (Sweden)

    David M Hudson

    Full Text Available Approximately half the proline residues in fibrillar collagen are hydroxylated. The predominant form is 4-hydroxyproline, which helps fold and stabilize the triple helix. A minor form, 3-hydroxyproline, still has no clear function. Using peptide mass spectrometry, we recently revealed several previously unknown molecular sites of 3-hydroxyproline in fibrillar collagen chains. In fibril-forming A-clade collagen chains, four new partially occupied 3-hydroxyproline sites were found (A2, A3, A4 and (GPPn in addition to the fully occupied A1 site at Pro986. The C-terminal (GPPn motif has five consecutive GPP triplets in α1(I, four in α2(I and three in α1(II, all subject to 3-hydroxylation. The evolutionary origins of this substrate sequence were investigated by surveying the pattern of its 3-hydroxyproline occupancy from early chordates through amphibians, birds and mammals. Different tissue sources of type I collagen (tendon, bone and skin and type II collagen (cartilage and notochord were examined by mass spectrometry. The (GPPn domain was found to be a major substrate for 3-hydroxylation only in vertebrate fibrillar collagens. In higher vertebrates (mouse, bovine and human, up to five 3-hydroxyproline residues per (GPPn motif were found in α1(I and four in α2(I, with an average of two residues per chain. In vertebrate type I collagen the modification exhibited clear tissue specificity, with 3-hydroxyproline prominent only in tendon. The occupancy also showed developmental changes in Achilles tendon, with increasing 3-hydroxyproline levels with age. The biological significance is unclear but the level of 3-hydroxylation at the (GPPn site appears to have increased as tendons evolved and shows both tendon type and developmental variations within a species.

  16. Transcranial Doppler-determined change in posterior cerebral artery blood flow velocity does not reflect vertebral artery blood flow during exercise.

    Science.gov (United States)

    Washio, Takuro; Sasaki, Hiroyuki; Ogoh, Shigehiko

    2017-04-01

    We examined whether a change in posterior cerebral artery flow velocity (PCAv) reflected the posterior cerebral blood flow in healthy subjects during both static and dynamic exercise. PCAv and vertebral artery (VA) blood flow, as an index of posterior cerebral blood flow, were continuously measured during an exercise trial using transcranial Doppler (TCD) ultrasonography and Doppler ultrasound, respectively. Static handgrip exercise significantly increased both PCAv and VA blood flow. Increasing intensity of dynamic exercise further increased VA blood flow from moderate exercise, while PCAv decreased to almost resting level. During both static and dynamic exercise, the PCA cerebrovascular conductance (CVC) index significantly decreased from rest (static and high-intensity dynamic exercise, -11.5 ± 12.2% and -18.0 ± 16.8%, means ± SD, respectively) despite no change in the CVC of VA. These results indicate that vasoconstriction occurred at PCA but not VA during exercise-induced hypertension. This discrepancy in vascular response to exercise between PCA and VA may be due to different cerebral arterial characteristics. Therefore, to determine the effect of exercise on posterior cerebral circulation, at least, we need to carefully consider which cerebral artery to measure, regardless of exercise mode.NEW & NOTEWORTHY We examined whether transcranial Doppler-determined flow velocity in the posterior cerebral artery can be used as an index of cerebral blood flow during exercise. However, the changes in posterior cerebral artery flow velocity during exercise do not reflect vertebral artery blood flow. Copyright © 2017 the American Physiological Society.

  17. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ozaki, Kumi, E-mail: ozakik-rad@umin.org [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan); Kobayashi, Satoshi [Kanazawa University Graduate School of Medical Science, Department of Quantum Medicine Technology (Japan); Matsui, Osamu; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan)

    2017-06-15

    PurposeTo investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.Materials and MethodsA total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.ResultsIn 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.ConclusionExtrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.

  18. Echocardiographic presentation of anomalous origin of the left coronary artery from the pulmonary artery.

    Science.gov (United States)

    Silverman, Norman H

    2015-12-01

    In the 1970s, diagnosing anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was often uncertain using imaging alone; however, with the advances in high-frequency transducers, advanced image processing, and other ultrasound modalities such as Doppler colour flow imaging, tissue Doppler imaging, and speckle tracking to asses regional wall motion abnormalities, modern echocardiography now permits accurate diagnosis of ALCAPA with greater certainty. Although many consider ultrasound to be the only imaging test necessary if there is a question as to the diagnosis, other imaging modalities such as MRI, CT, and cardiac catheterisation with angiography remain valuable complementary tests, especially in older patients.

  19. A Study of the Relationship between Syncope Attacks and Diminished Carotid and Vertebral Artery Flow Using Doppler Ultrasonography of Cervical Vessels

    Directory of Open Access Journals (Sweden)

    V Shaygan Nejad

    2005-03-01

    Full Text Available Background:Syncope or drop attack is a common and potentially serious condition and prompt evaluation of the affected patients should be evaluated prompting for cardiac disease, seizure, structural lesions of the brain or peripheral nerves, as well as drug induced and metabolic disturbances. This study was conducted to evaluate carotid and vertebral arteries blood flow in patients with syncope in which other etiologies had been ruled out. Methods: This one-year retrospective case-control study involved 33 patients (case group and 33 normal individuals (control group. Carotid and vertebral arteries blood flow was measured in all subjects (ml/min and SPSS was used for data analysis. Results: Mean blood flow in vertebral arteries in the case group was significantly lower than in the control group (P<0.001, however mean carotid artery flow was not significantly different between them (P=0.58. Conclusion: Based on our results and findings of some other studies, we recommend duplex ultrasonography of vertebral and cervical arteries in patients suffering from drop attacks, after ruling out the prominent etiologies, such as seizure, heart disease, etc. Keywords: syncope, ultrasound, carotid artery, vertebral artery

  20. Long-term outcome of endovascular treatment versus medical care for carotid artery stenosis in patients not suitable for surgery and randomised in the Carotid and Vertebral Artery Transluminal Angioplasty study (CAVATAS).

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-01-01

    Optimal treatment of carotid stenosis in patients not suitable for surgery is unclear. The Carotid and Vertebral Artery Transluminal Angioplasty study contained a trial comparing medical and endovascular treatment in patients not suitable for surgery.

  1. [Tetralogy of Fallot with anomalous origin of unilateral pulmonary artery].

    Science.gov (United States)

    Endo, M; Haneda, K; Suzuki, Y; Mohri, H; Yamaki, S

    1991-02-01

    Between 1971 and 1988, 7 patients (pts) of TOF with anomalous origin of unilateral pulmonary artery (AOPA) underwent intracardiac repair at Tohoku University Hospital. They were 2 males and 5 females, with ages ranging from 4 to 26 years old. The right PA originated from the RV in all cases, whereas the left PA originated from the ascending aorta in 2 pts (Group 1) and from the ductus arteriosus in 5 pts (Group 2 & 3). In Group 2 (2 pts), the left PA was separated from the right PA with intraluminal membrane. In Group 3 (3 pts), there was no communication between both pulmonary arteries. The left PA was reconstructed in Group 1 & 2. However, it was impossible to reconstruct the left PA in Group 3 since the ductus arteriosus and left PA had been occluded before intracardiac repair. In Group 3, VSD was closed with one-way (RV----LV) valved patch for the aim of lowering RV pressure. Postoperative RV/Ao pressure ratio was 0.5-0.8 in the cases of Group 1 & 2, 0.8-1.0 in Group 3. Three patients (one in each group) died postoperatively due to low output syndrome. Autopsy revealed pulmonary vascular obstructive disease (PVOD) of the left lung in Group 1. It is concluded that TOF with AOPA should be corrected before the advance of PVOD in case PA originate from the ascending aorta, and before the occlusion of the ductus in case PA originate from it, in order to prevent postoperative RV overload.

  2. Transposable elements are major contributors to the origin, diversification, and regulation of vertebrate long noncoding RNAs.

    Directory of Open Access Journals (Sweden)

    Aurélie Kapusta

    2013-04-01

    Full Text Available Advances in vertebrate genomics have uncovered thousands of loci encoding long noncoding RNAs (lncRNAs. While progress has been made in elucidating the regulatory functions of lncRNAs, little is known about their origins and evolution. Here we explore the contribution of transposable elements (TEs to the makeup and regulation of lncRNAs in human, mouse, and zebrafish. Surprisingly, TEs occur in more than two thirds of mature lncRNA transcripts and account for a substantial portion of total lncRNA sequence (~30% in human, whereas they seldom occur in protein-coding transcripts. While TEs contribute less to lncRNA exons than expected, several TE families are strongly enriched in lncRNAs. There is also substantial interspecific variation in the coverage and types of TEs embedded in lncRNAs, partially reflecting differences in the TE landscapes of the genomes surveyed. In human, TE sequences in lncRNAs evolve under greater evolutionary constraint than their non-TE sequences, than their intronic TEs, or than random DNA. Consistent with functional constraint, we found that TEs contribute signals essential for the biogenesis of many lncRNAs, including ~30,000 unique sites for transcription initiation, splicing, or polyadenylation in human. In addition, we identified ~35,000 TEs marked as open chromatin located within 10 kb upstream of lncRNA genes. The density of these marks in one cell type correlate with elevated expression of the downstream lncRNA in the same cell type, suggesting that these TEs contribute to cis-regulation. These global trends are recapitulated in several lncRNAs with established functions. Finally a subset of TEs embedded in lncRNAs are subject to RNA editing and predicted to form secondary structures likely important for function. In conclusion, TEs are nearly ubiquitous in lncRNAs and have played an important role in the lineage-specific diversification of vertebrate lncRNA repertoires.

  3. Rare high origin of the radial artery: a bilateral, symmetrical case ...

    African Journals Online (AJOL)

    Arterial variations in the upper limb can occur at the level of the axillary, brachial, radial and ulnar arteries as well as the palmar arches. This is a report of bilateral, symmetrical high origin of the radial artery from the axillary artery. Knowledge of such variations is important in vascular and reconstructive surgery. (Nig J Surg ...

  4. Endovascular treatment of giant p1/p2 aneurysm by direct puncture of the vertebral artery. Case report.

    Science.gov (United States)

    Szajner, M; Obsza Ska, K; Nestorowicz, A; Szczerbo-Trojanowska, M; Trojanowski, T

    2003-12-20

    Vascular access is usually achieved through a femoral arterial puncture using a modified Seldinger technique. However, selective catheterization of the great cerebral vessels by femoral approach fails completely when the vessel is tortuous or atheromatous. In case of posterior vascular circulation aneurysms, transbrachial approach or direct puncture of the vertebral artery (VA) is an alternative. The aneurysms of the posterior cerebral artery (PCA) are reported to be rare. Due to unfavorable anatomic location, the PCA aneurysms are difficult to reach during surgical procedure. Endovascular embolization is at present considered to be more effective and safer treatment of the PCA aneurysms arising from different segments, offering a viable alternative to the surgical approach. We report the case of the giant left PCA aneurysm, located at the junction of P1/P2 segments, successfully treated by parent artery occlusion achieved after the direct puncture of the right VA which was used because both VAs were tortuous, irregular and their ostia were not accessible by femoral approach. According to different authors, parent artery occlusion appears to be safe in the treatment of P2 segment aneurysms, whatever the location of the occlusion. In our case we decided to perform this kind of treatment believing it was the only possible one.

  5. Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma

    Directory of Open Access Journals (Sweden)

    Almerindo Júnior

    2010-06-01

    Full Text Available Abstract Background Blunt carotid and vertebral artery injury (BCVI occur infrequently. The incidence of this type of injury is difficult to determine as many emergency room patients are neurologically asymptomatic. The statistics have not been reported in Brazil. The objectives of the current study were: To evaluate the accuracy of criteria used to recommend angiotomography in the diagnosis of cervical BCVI in 100 patients with blunt cervical trauma in the trauma services section of a Brazilian quaternary care hospital. Methods During a 30-month (2006-2008, all patients admitted to the emergency room of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo with blunt cervical trauma and potential risk of cervical vessel injury, were subjected to cervical angiotomography to diagnose BCVI. The data analyzed are presented as mean ± standard deviation, and statistical analyses included Chi-square and Fisher's exact tests, and the Mann-Whitney test. Results During the study period 2467 blunt trauma patients were admitted. In 100 patients that met the criteria for inclusion in the study, angiotomography identified 23 with BCVI, including 17 males and six females. The mean patient age was 34.81 ± 14.84 years. Car crash (49% and car-pedestrian accidents (24% were the most frequent causes of injury. Ten patients had internal carotid artery injuries, two patients had common carotid artery injuries, and 11 patients had vertebral artery injuries. Seven patients presented with Degree I arterial injuries, 10 patients presented with Degree II artery injuries, four patients presented with Degree IV artery injuries, one patient presented with a Degree V artery injury, and one patient had a carotid fistula. Seven out of the 23 patients with BCVI (30.4% presented with cervical vertebrae fractures, and 11 out of the 23 patients with BCVI (47.8% presented with facial fractures (LeFort II and III. Conclusions Although there is no consensus

  6. Diagnosis of a C3 segmental type of vertebral artery by magnetic resonance angiography: report of two cases.

    Science.gov (United States)

    Uchino, Akira; Saito, Naoko; Uemiya, Nahoko; Sonoda, Ken-Ichiro

    2016-09-01

    We report two cases in which the vertebral artery (VA) entered the spinal canal via the intervertebral foramen at the C2-C3 disc level, an extremely rare variation regarded as a C3 segmental type of VA, that we diagnosed by magnetic resonance angiography. The C2 segmental type of VA, in which the VA enters the spinal canal via the C1-C2 intervertebral space, is relatively common. It is important to identify these variations before surgery of the craniovertebral junction or interventional procedures to prevent complications.

  7. Posterior atlantoaxial fusion as treatment option for extracranial vertebral artery dissecting aneurysm: a case report and literature review.

    Science.gov (United States)

    Ikeda, Naokado; Hayashi, Hideki; Goto, Masanori; Satoi, Hitoshi; Iwasaki, Koichi; Toda, Hiroki

    2016-09-01

    Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneurysm. Dynamic angiography showed the dissecting aneurysm of the V3 segment in the neutral head position, and deflation of the aneurysm during rightward head rotation. She underwent posterior atlantoaxial fusion, and the lesion was repaired with no subsequent ischemia. Posterior atlantoaxial fusion can be an option for some extracranial VA dissections with preserving its anterograde blood flow.

  8. Evolutionary and Expression Analyses Show Co-option of khdrbs Genes for Origin of Vertebrate Brain

    OpenAIRE

    Su Wang; Su Wang; Qingyun Yang; Qingyun Yang; Ziyue Wang; Ziyue Wang; Shuoqi Feng; Shuoqi Feng; Hongyan Li; Hongyan Li; Dongrui Ji; Dongrui Ji; Shicui Zhang; Shicui Zhang

    2018-01-01

    Genes generated by whole genome duplications (WGD) can be co-opted by changing their regulation process or altering their coding proteins, which has been shown contributable to the emergence of vertebrate morphological novelties such as vertebrate cartilage. Mouse khdrbs genes, differing from its invertebrate orthologs, were mainly expressed in brain, hinting that khdrbs gene family as a member of genetic toolkit may be linked to vertebrate brain development. However, the evolutionary relatio...

  9. Surgical treatment of aberrant aortic origin of coronary arteries.

    Science.gov (United States)

    Kooij, Marlotte; Vliegen, Hubert W; de Graaf, Michiel A; Hazekamp, Mark G

    2015-11-01

    Aberrant origin of the coronary arteries is rare but can be life threatening. It is an important cause of sudden death in athletes and other young adults, and may be treated surgically. Consensus exists that interarterial left coronary artery (LCA) should be surgically repaired. For interarterial right coronary artery (RCA), the discussion remains open. The purpose of this study was to analyse our surgical experience. From 2001 until 2014, 31 patients were operated for interarterial RCA, interarterial LCA or intraseptal course of the LCA. Twenty-six patients had interarterial RCA, 4 patients interarterial LCA and 1 patient an intraseptal course of the LCA. Median age at operation was 38 years (range 9-66 years). Twenty-eight patients had previous or current symptoms. The most important were a life-threatening event with resuscitation in 3 and myocardial infarction in 3 others. Surgical repair of interarterial RCA consisted of unroofing of the ostium with or without reimplantation in 25 patients and CABG on the RCA with a venous graft in 1 patient. Reconstruction of interarterial LCA consisted of ostium reconstruction of the LCA with a venous patch in 4 patients. The patient with an intraseptal course had a complete release of the LCA out of the septum and reimplantation in the correct coronary sinus. Follow-up was done by analysis of outpatient records, direct patient contact, echocardiography, electrocardiography, CT-angiography and an exercise test. Median follow-up was 6 years (range 0-11 years). One patient was lost to follow-up. No early or late mortality occurred. Three patients had ischaemia with ventricular fibrillation or ventricular tachycardia shortly after surgery. Two were immediately reoperated, 1 had a stent implantation 1.5 months after release of intraseptal LCA. Two of these patients show a slight dysfunction of the left ventricle at follow-up. All other patients are asymptomatic. Surgery for aberrant origin of coronary arteries is safe. There is

  10. Subaxial rotational vertebral artery syndrome: resection of the uncinate process and anterior fusion can be sufficient!: case report and review of the literature.

    Science.gov (United States)

    Schelfaut, Sebastiaan; Verhasselt, Skrallan; Carpentier, Karel; Moke, Lieven

    2015-03-01

    A case report on rotational vertebral artery syndrome (RVAS) and surgical treatment. To illustrate a safe treatment option of RVAS with diminished risk of iatrogenic damage to the vertebral artery. RVAS is an uncommon cause of symptomatic transient vertebrobasilar insufficiency induced by physiological head rotation with temporary significant external compression of the dominant subaxial vertebral artery. Previous reports state that the treatment of choice consists of decompression of the vessel with resection of the anterior rim of the transverse process and any fibrotic sheet or intertransverse muscle, if necessary, combined with an anterior cervical discectomy and fusion (ACDF) with uncus resection. This is a case report on RVAS and its surgical treatment. The diagnosis of RVAS due to an osteophyte of the uncinate process at level C5/C6 was confirmed using computed tomographic angiography. We performed a classic ACDF using the contralateral approach with complete resection of the uncovertebral joint at the pathologic site. In our case, the symptoms of transient vertebrobasilar insufficiency induced by head rotation completely resolved postoperatively, and computed tomographic angiography images at 3 months postoperatively showed good bony ingrowth and restoration of vertebral artery patency during extreme rotation. Classic ACDF with complete resection of the uncovertebral joint is a safe treatment option for RVAS in the subaxial cervical spine. Fusion at the pathologic level will eliminate rotation and prevent further formation of osteophytes at the operated level. Unroofing of the vertebral artery seems not always necessary, diminishing the surgical risk.

  11. Duplicate origin of the anterior cerebral artery diagnosed by magnetic resonance angiography: a case report.

    Science.gov (United States)

    Uchino, Akira; Saito, Naoko; Nagamine, Yuito; Takao, Masaki

    2016-12-01

    An anterior cerebral artery (ACA) of duplicate origin results from the fusion of two arteries that arise from the terminal segment of the internal carotid artery (ICA) to form a ring. This variation is extremely rare and differs from proximal ACA fenestration, supraclinoid fenestration of the ICA, and duplicate origin of the middle cerebral artery. We report a case diagnosed incidentally by magnetic resonance angiography.

  12. Pipeline embolization of posterior communicating artery aneurysms associated with a fetal origin posterior cerebral artery.

    Science.gov (United States)

    Wallace, Adam N; Kayan, Yasha; Austin, Matthew J; Delgado Almandoz, Josser E; Kamran, Mudassar; Cross, DeWitte T; Moran, Christopher J; Osbun, Joshua W; Kansagra, Akash P

    2017-09-01

    Flow diversion may have advantages in the treatment of posterior communicating artery (PComA) aneurysms associated with a fetal origin posterior cerebral artery (PCA), which can be challenging to treat with conventional techniques. However, a PComA incorporated into the aneurysm may prevent or delay aneurysm occlusion. Also, coverage of a fetal origin PCA risks infarction of a large vascular territory. The purpose of this study was to examine the safety and effectiveness of using the Pipeline Embolization Device (PED) to treat PComA aneurysms associated with a fetal origin PCA. Retrospective review of PComA aneurysms associated with a fetal origin PCA treated with the PED at two neurovascular centers was performed. Periprocedural complications and clinical and angiographic outcomes were reviewed. Seven female patients underwent a total of seven PED procedures to treat seven PcomA aneurysms associated with a fetal origin PCA. The symptomatic complication rate was 14% (1/7) per patient and 13% (1/8) per procedure. Angiographic follow up was obtained for 6 of 7 aneurysms. Follow-up DSA at 5-7 months after treatment demonstrated complete occlusion of 17% (1/6) of aneurysms. One aneurysm was retreated with a second PED and occlusion was demonstrated 36 months after the second treatment, yielding an overall complete occlusion rate of 33% (2/6). PED treatment was largely ineffective at treating PComA aneurysms associated with a fetal origin PCA, and should only be considered when conventional treatment options, including microsurgical clipping, are not feasible. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-10-01

    Endovascular treatment (angioplasty with or without stenting) is an alternative to carotid endarterectomy for carotid artery stenosis but there are scarce long-term efficacy data showing that it prevents stroke. We therefore report the long-term results of the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS).

  14. Transposable Elements Are Major Contributors to the Origin, Diversification, and Regulation of Vertebrate Long Noncoding RNAs

    Science.gov (United States)

    Kapusta, Aurélie; Zhuo, Xiaoyu; Ramsay, LeeAnn; Bourque, Guillaume; Yandell, Mark; Feschotte, Cédric

    2013-01-01

    Advances in vertebrate genomics have uncovered thousands of loci encoding long noncoding RNAs (lncRNAs). While progress has been made in elucidating the regulatory functions of lncRNAs, little is known about their origins and evolution. Here we explore the contribution of transposable elements (TEs) to the makeup and regulation of lncRNAs in human, mouse, and zebrafish. Surprisingly, TEs occur in more than two thirds of mature lncRNA transcripts and account for a substantial portion of total lncRNA sequence (∼30% in human), whereas they seldom occur in protein-coding transcripts. While TEs contribute less to lncRNA exons than expected, several TE families are strongly enriched in lncRNAs. There is also substantial interspecific variation in the coverage and types of TEs embedded in lncRNAs, partially reflecting differences in the TE landscapes of the genomes surveyed. In human, TE sequences in lncRNAs evolve under greater evolutionary constraint than their non–TE sequences, than their intronic TEs, or than random DNA. Consistent with functional constraint, we found that TEs contribute signals essential for the biogenesis of many lncRNAs, including ∼30,000 unique sites for transcription initiation, splicing, or polyadenylation in human. In addition, we identified ∼35,000 TEs marked as open chromatin located within 10 kb upstream of lncRNA genes. The density of these marks in one cell type correlate with elevated expression of the downstream lncRNA in the same cell type, suggesting that these TEs contribute to cis-regulation. These global trends are recapitulated in several lncRNAs with established functions. Finally a subset of TEs embedded in lncRNAs are subject to RNA editing and predicted to form secondary structures likely important for function. In conclusion, TEs are nearly ubiquitous in lncRNAs and have played an important role in the lineage-specific diversification of vertebrate lncRNA repertoires. PMID:23637635

  15. The anomalous origin of the branch pulmonary artery from the ascending aorta

    OpenAIRE

    Garg, Pankaj; Talwar, Sachin; Kothari, Shyam Sunder; Saxena, Anita; Juneja, Rajnish; Choudhary, Shiv Kumar; Airan, Balram

    2012-01-01

    The anomalous origin of one pulmonary artery branch from the aorta (AOPA) is rare. We report our single-institution surgical experience with this condition. Between January 1994 and February 2011, 17 patients (age: 1 month–25 years) with AOPA underwent surgery at our institute. Thirteen patients had an anomalous origin of the right pulmonary artery (RPA) while four had an anomalous origin of the left pulmonary artery (LPA) from the aorta. In patients with anomalous RPA, 11 patients had the pr...

  16. Headache characteristics of uncomplicated intracranial vertebral artery dissection and validation of ICHD-3 beta diagnostic criteria for headache attributed to intracranial artery dissection.

    Science.gov (United States)

    Kim, Jae-Gyum; Choi, Jeong-Yoon; Kim, Sung Un; Jung, Jin-Man; Kwon, Do-Young; Park, Moon Ho; Oh, Kyungmi

    2015-05-01

    Headache may be a warning sign of subsequent stroke in patients with vertebral artery dissection (VAD). Even though the headache characteristics of VAD have been described predominantly in patients with extracranial VAD and neurological complications, headache semiology is not well known in patients with uncomplicated intracranial vertebral artery dissection (ICVAD). In the present study, we attempt to identify the headache semiology that characterizes ICVAD and validate the revised version of the International Classification of Headache Disorders (ICHD-3 beta) criteria for headache attributed to intracranial artery dissection. Six patients with neurologically uncomplicated ICVAD presented at a participating medical center, and eight similar patients were reviewed in the literature. Combining these data, we analyzed headache characteristics of patients with uncomplicated ICVAD according to their pain onset and duration, nature, intensity, location, aggravating and relieving factors, associated symptoms, response to medication, and prognosis. Headache in uncomplicated ICVAD usually has an acute mode of onset (11/14) and persistent (10/14) temporal feature. Pain that has a throbbing quality (nine of 14) and severe intensity (13/14) on the ipsilesional (10/14) and occipitonuchal area (12/14) is a headache prototype in ICVAD. Additionally, headache was intensified by head flexion and rotation (three of six), and relieved by head extension and supine positioning (five of six). Headache of all patients in the present study fulfilled the ICHD-3 beta criteria. Headache semiology of uncomplicated ICVAD is mostly homogenous in the present study. These characteristics may be helpful in the diagnosis of uncomplicated ICVAD. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Clinical features and outcomes of spinal cord infarction following vertebral artery dissection: a systematic review of the literature.

    Science.gov (United States)

    Hsu, Chia-Yu; Cheng, Chun-Yu; Lee, Jiann-Der; Lee, Meng; Huang, Ying-Chih; Wu, Chih-Ying; Hsu, Huan-Lin; Lin, Ya-Hui; Huang, Yen-Chu; Weng, Hsu-Huei; Huang, Kuo-Lun

    2013-09-01

    Spinal cord infarction (SCI) is a rare complication of vertebral artery dissection (VAD). Its clinical features and outcomes have not yet been well documented. In addition to reporting a case with bilateral SCI caused by left VAD, we performed a systematic review of the literature conducted through a PubMed search. A total of 17 cases were reviewed (nine men and eight women). The average age was 40·5±14·6 years. In addition to neck pain or headache (88%), patients with VAD-associated SCI often presented with a sensory level (76%) or Brown-Séquard syndrome (53%). The most common regions of dissection were at the V1 or proximal V2 segments, and the infarcted area of SCI was mainly located at C2-C5 levels. Regarding the vascular territory, posterior spinal artery infarction was noted in 29% of patients, spinal sulcal artery infarction in 42%, and anterior spinal artery (ASA) watershed infarction in 29%. Eleven patients (65%) had a good outcome and six patients (35%) had a poor outcome (including one mortality; 6%). Smoking, age above 50 years, and ASA watershed infarction were associated with a poor outcome, while spinal sulcal artery infarction was associated with a good outcome. Neck pain or headache is an important warning symptom of VAD, and the presence of a concomitant sensory level or Brown-Séquard syndrome is helpful for the early diagnosis of SCI caused by VAD. One-third of patients had a poor outcome, and smoking, old age, and ASA watershed infarction represented important risk factors.

  18. Histology of the heterostracan dermal skeleton: Insight into the origin of the vertebrate mineralised skeleton

    Science.gov (United States)

    Marquart, Chloe L.

    2015-01-01

    ABSTRACT Living vertebrates are divided into those that possess a fully formed and fully mineralised skeleton (gnathostomes) versus those that possess only unmineralised cartilaginous rudiments (cyclostomes). As such, extinct phylogenetic intermediates of these living lineages afford unique insights into the evolutionary assembly of the vertebrate mineralised skeleton and its canonical tissue types. Extinct jawless and jawed fishes assigned to the gnathostome stem evidence the piecemeal assembly of skeletal systems, revealing that the dermal skeleton is the earliest manifestation of a homologous mineralised skeleton. Yet the nature of the primitive dermal skeleton, itself, is poorly understood. This is principally because previous histological studies of early vertebrates lacked a phylogenetic framework required to derive evolutionary hypotheses. Nowhere is this more apparent than within Heterostraci, a diverse clade of primitive jawless vertebrates. To this end, we surveyed the dermal skeletal histology of heterostracans, inferred the plesiomorphic heterostracan skeleton and, through histological comparison to other skeletonising vertebrate clades, deduced the ancestral nature of the vertebrate dermal skeleton. Heterostracans primitively possess a four‐layered skeleton, comprising a superficial layer of odontodes composed of dentine and enameloid; a compact layer of acellular parallel‐fibred bone containing a network of vascular canals that supply the pulp canals (L1); a trabecular layer consisting of intersecting radial walls composed of acellular parallel‐fibred bone, showing osteon‐like development (L2); and a basal layer of isopedin (L3). A three layered skeleton, equivalent to the superficial layer L2 and L3 and composed of enameloid, dentine and acellular bone, is possessed by the ancestor of heterostracans + jawed vertebrates. We conclude that an osteogenic component is plesiomorphic with respect to the vertebrate dermal skeleton. Consequently, we

  19. The Relationship Between Health Related Quality of Life and Vertebral Fracture in Postmenopausal Osteoporosis - Original Investigation

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    Selmin Gülbahar

    2007-06-01

    Full Text Available Aim: The aim of this study was to evaluate the relationship between vertebral fracture and quality of life in postmenopausal osteoporotic patients. Osteoporosis is a disease characterized by low bone mass and structural detoriation of bone tissue, leading to bone fragility and increased susceptibility to fractures. Fracture formation is the most important complication of osteoporosis. Vertebral fractures cause back pain, sleep disorders, depression, and incapacity in daily activities and all these entities decrease quality of life. Patients and Methods: Thirty five female patients with postmenopausal osteoporosis were enrolled in this study. Bilaterally dorsal and lumbar spine radiographs were used to investigate the existence of vertebral compression fracture. Anterior, middle and posterior heights of vertebral bodies (T4-L5 have measured on lateral spine radiographs and the number of vertebrae with fracture were determined. Bone mineral density were measured by using Dual Energy X Ray Absorbtiometry (DXA at the lumbar spine (L1-4 and proximal femur. Quality of life was assessed by using Quality of Life Questionnaire of the European Foundation For Osteoporosis (QUALEFFO. Results: The mean number of vertebral fractures was 2.14±2.17. There was a correlation between fractures and quality of life pain, physical function, general health assesment, mental function scores and the total score. No significant correlation was found for social function scores. Moreover a positive relation was detected between number of vertebral fractures and age. When bone mineral density values and quality of life scores of the groups were compared, the group having vertebral fractures had lower density and poorer quality of life scores but no statistically significant difference was detected. Conclusion: Osteoporotic vertebral fractures affect quality of life negatively. We suggest that during the treatment and follow up of patients with osteoporosis, quality of life

  20. Separate origin of the main components of the left coronary artery in Syrian hamsters (Mesocricetus auratus).

    Science.gov (United States)

    Durán, A C; Arqué, J M; Fernández, B; Fernández, M C; Fernández-Gallego, T; Sans-Coma, V

    2007-08-01

    This study describes a rare congenital coronary artery anomaly in the Syrian hamster; namely, the separate origin of the obtuse marginal and left circumflex arteries which are the main components of the left coronary artery. The hearts of nine affected animals were examined by means of a corrosion-cast technique and histology. The hamsters belonged to a laboratory inbred family with a high incidence of coronary artery anomalies and bicuspid aortic valve. The aortic valve was tricuspid in three hamsters and bicuspid in the other six hamsters. In all cases, the right coronary artery was normal, whereas the left coronary artery main trunk was absent. The present anomalous coronary artery patterns could be classified into two main entities: (i) ectopic origin of the obtuse marginal artery from the right aortic sinus or from the right coronary artery, with the left circumflex artery arising from the left side of the aortic valve; and (ii) ectopic origin of both the obtuse marginal artery from the right aortic sinus or from the right coronary artery and left circumflex artery from the dorsal aortic sinus. In all cases, the obtuse marginal artery coursed to the right side of the heart through the ventral wall of the right ventricular outflow tract. When the left circumflex artery arose from the dorsal aortic sinus, it formed an acute angle with the aortic wall. This report seems to be the first to describe the separate origin of the main components of the left coronary artery in a non-human mammalian species. In man, the congenital coronary artery and aortic valve defects reported herein may entail the risk of clinical complications. However, none of the affected hamsters showed signs of disease.

  1. Changes of blood flow velocity indicating mechanical compression of the vertebral arteries during rotation of the head in the normal human measured with transcranial Doppler sonography

    OpenAIRE

    Rossiti, Sandro; Volkmann, Reinhard

    1995-01-01

    The dynamical changes of blood flow velocity of the intracranial vertebral arteries (VA's) and proximal basilar artery (BA) provoked by rotation of the head in normal volunteers were measured using pulsed-wave transcranial Doppler sonography (TCD). In another group both VA's were examined simultaneously with 2-channel TCD. Blood flow velocities diminished compared to the neutral position in all vessels, independently of die side. Total obstruction of the flow was not observed. Our findings re...

  2. A stem-deuterostome origin of the vertebrate pharyngeal transcriptional network

    Science.gov (United States)

    Gillis, J. Andrew; Fritzenwanker, Jens H.; Lowe, Christopher J.

    2012-01-01

    Hemichordate worms possess ciliated gills on their trunk, and the homology of these structures with the pharyngeal gill slits of chordates has long been a topic of debate in the fields of evolutionary biology and comparative anatomy. Here, we show conservation of transcription factor expression between the developing pharyngeal gill pores of the hemichordate Saccoglossus kowalevskii and the pharyngeal gill slit precursors (i.e. pharyngeal endodermal outpockets) of vertebrates. Transcription factors that are expressed in the pharyngeal endoderm, ectoderm and mesenchyme of vertebrates are expressed exclusively in the pharyngeal endoderm of S. kowalevskii. The pharyngeal arches and tongue bars of S. kowalevskii lack Tbx1-expressing mesoderm, and are supported solely by an acellular collagenous endoskeleton and by compartments of the trunk coelom. Our findings suggest that hemichordate and vertebrate gills are homologous as simple endodermal outpockets from the foregut, and that much vertebrate pharyngeal complexity arose coincident with the incorporation of cranial paraxial mesoderm and neural crest-derived mesenchyme within pharyngeal arches along the chordate and vertebrate stems, respectively. PMID:21676974

  3. A New Anatomic Variation: Coexistence of Both Dandy-Walker Variant and Ophthalmic Artery Originating From Contralateral Internal Carotid Artery.

    Science.gov (United States)

    Ogul, Hayri; Havan, Nuri; Gedikli, Yusuf; Pirimoglu, Berhan; Kantarci, Mecit

    2016-06-01

    The authors report on 1 patient of variant origin of right ophthalmic artery (OA) from ophthalmic segment of the left internal carotid artery. A 41-year-old man was performed magnetic resonance (MR) imaging and MR angiography. Cerebral MR imaging revealed a Dandy-Walker variant. In MR angiography the authors observed this unusual variant of origin of OA and a complete occlusion of right internal carotid artery. To the authors' knowledge, this is the first patient who has coincidence of both Dandy-Walker variant and origin of OA from contralateral internal carotid artery. Careful observation of MR angiography images with maximum intensity projection is very important for detecting rare vascular variations.

  4. Case Report: Variant Origin of an Arterial Trunk from Axillary Artery ...

    African Journals Online (AJOL)

    Conclusion: Since the axillary artery is next choice of artery for arterial canulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors. Keywords: axillary artery, common trunk, profunda brachii, ...

  5. [Clinical diagnostic of brain death and transcranial Doppler, looking for middle cerebral arteries and intracranial vertebral arteries. Agreement with scintigraphic techniques].

    Science.gov (United States)

    Nebra, A C; Virgós, B; Santos, S; Tejero, C; Larraga, J; Araiz, J J; Sánchez, J I; Suárez, M A; Millastre, A

    The Real Ordinance 2070/1999 meant an important modification in the legislation, when including transcranial Doppler (TCD) in explorations to confirm the clinical diagnosis of brain death (BD). Habitually for their employment in the diagnosis of BD, we look for blood flow signal from the middle cerebral arteries (MCA) and the basilar artery (BA). To check the effectiveness of the TCD like test of BD, looking for both middle cerebral arteries (MCA) and both intracranial vertebral arteries (VA), instead of the BA, and taking as Gold Standard cerebral scintigraphic techniques. . We present 25 patients diagnosed clinically with BD; on these TCD was carried out to confirm BD. Later on we proceeded to carry out cerebral scintigraphic techniques in all these cases. As statistical tool the test of c2 is used with confidence interval of 95%. In 24 of the 25 cases, the TCD was effective in confirming the diagnosis of BD. In the remaining patient, a false positive result was obtained, since the TCD didn't reveal flow in the infratentorial compartment, as contrary to the cerebral scintigraphic techniques which showed the presence of residual flow at this level; this residual flow disappeared in 36 hours. This patient was hemodynamically unstable during TCD exploration. In our results the TCD obtains a reliability of 100% when confirming the absence of blood flow in the supratentorial compartment; nevertheless the false positive result obtained at the infratentorial level, warns us to be cautious in accepting the flow from the VA as a test of absence of flow at the infratentorial compartment, especially in those patients with hemodynamic instability.

  6. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA in an Old Adult

    Directory of Open Access Journals (Sweden)

    Maryam Esmaeilzadeh

    2011-09-01

    Full Text Available The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a rare congenital cardiac malformation. It presents predominantly in infancy and its main presenting feature is myocardial ischemia or heart failure. Survival to adulthood is quite uncommon. If untreated, mortality from ALCAPA approaches 90% in infancy; early recognition and surgical correction are, therefore, essential. With early surgical correction, the prognosis is good. There are two types of ALCAPA syndrome: the infant type and the adult type, each of which has different manifestations and outcomes. Infants experience myocardial infarction and congestive heart failure, and approximately 90% die within the first year of life. A literature review regarding this anomaly in teenagers and adults show that only 25 cases have been diagnosed during life and 18 additional cases of ALCAPA in these age groups have been diagnosed post mortem. We present a rare case of a 60-year-old man, who referred to our center due to dyspnea on exertion from the previous year without any history of chest pain and diagnosed as ALCAPA. Given the absence of ischemia and the patient’s age, only medical therapy was recommended.

  7. A RARE CASE OF ORIGIN OF THE SUPERIOR THYROID ARTERY FROM THE RIGHT COMMON CAROTID ARTERY

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    Y MOHAMADI

    1982-05-01

    Full Text Available Recent l y i n a clas sroom d is sect i on we f ounu an anoma l ou s superior thyroid artery in a 60-year -ol d man . The arte ry originated f rom t he common carotid 31 mm p rox imal t o its bifurcation . Rega r d i ng t o the s ex , the s i de and p lace o f o r i g i n , this could be a unique case , suggesting a need for more awarene s s o f any unpredictable anomal y whi ch may be s een i n th i s a r ter y t o avo id serious problems during s ur ger y on the thyroid gland .

  8. Long-term outcome of tandem stenting for stenoses of the intracranial vertebrobasilar artery and vertebral ostium.

    Science.gov (United States)

    Du, B; Wong, E H C; Jiang, W-J

    2009-04-01

    Patients with symptomatic atherosclerotic stenosis of the intracranial vertebrobasilar artery (VBA) have a poor prognosis, and those with coexistent intracranial and extracranial stenoses have worse outcomes despite medical therapy. Our aim was to study the long-term outcome of patients with symptomatic atherosclerotic tandem stenoses at the intracranial VBA and the vertebral artery ostium (VAO) after elective stent placement. Ten consecutive patients (mean age, 65.3 years) with this condition underwent elective stent placement at our institution between September 2001 and December 2007. Technical success was defined as stent placement of both VAO and intracranial VBA stenoses with complete stent coverage of the lesions, residual stenosis of VBA territory after 30 days. Technical success was obtained in 9 of 10 patients without any stroke or death within 30 days. During a median follow-up duration of 32 months, 1 patient had a fatal ischemic stroke in the VBA territory at 4 months, and the other 9 patients were free from stroke recurrence. Thus, the annual stroke rate in VBA territory (including any stroke or death within 30 days) was 3.8%. This pilot study shows that elective stent placement for patients with symptomatic atherosclerotic tandem stenoses at the intracranial VBA and VAO has an acceptable long-term outcome and may be considered as an alternative to medical therapy.

  9. Bilateral inverted vertebral arteries (V3 segment) in a case of congenital atlantoaxial dislocation: Distinct entity or a lateral variant of persistent first intersegmental artery?

    Science.gov (United States)

    Salunke, Pravin; Sahoo, Sushanta K.; Ghuman, Mandeep S.

    2014-01-01

    Background: Anomalous vertebral arteries (VAs), commonly involving the persistent first intersegmental artery (FIA), are often seen with congenital atlantoaxial dislocations (AAD). Here we describe an unusual variant consisting of bilateral VAs with normal loops but passing below the C1 (inverted VA) arch, distinctly different from the FIA. Case Description: A 9-year-old boy presented with a spastic quadriparesis. Preoperative radiographic studies showed an irreducible AAD with an occipitalized CO-C1 and C2-3 fusion. Although both VAs exhibited proximal and distal loops like normal VA, the distal loops did not pass through the C1 transverse foramina and coursed inferior to the C1 arch instead. With this critical preoperative information, both VAs could be better safeguarded during dissection of the C1-2 facets. Conclusion: In the case presented, although the course of the inverted VAs is similar, the norm, they coursed inferior to both C1 arches. Careful evaluation of the preoperative radiological studies allowed for careful dissection of the inverted VA (horizontal loop) while opening the C1-2 joint for subsequent alignment (e.g. reduction) and bony fusion. This information also facilitates safer insertion of lateral mass screws (e.g. choosing the appropriate C1 screw length to gain adequate bony purchase without compromising anomalous VA). PMID:25024882

  10. Accessory right hepatic artery originating from the superior ...

    African Journals Online (AJOL)

    Materials and Method: The abdomens of 8 adult male black African cadavers were dissected according to the description and guidance by Romanes (1996). The superior mesenteric arteries, liver (especially the visceral surfaces), gall bladders, cystic ducts, portal veins and gastroduodenal arteries were exposed. Results: ...

  11. The problem of the origin of primordial germ cells (PGCs) in vertebrates: historical review and a possible solution.

    Science.gov (United States)

    Pilato, Giovanni; D'Urso, Vera; Viglianisi, Fabio; Sammartano, Francesca; Sabella, Giorgio; Lisi, Oscar

    2013-01-01

    A concise review of the articles about the origin of primordial germ cells (PGCs) in vertebrates is provided. Differences among various taxa concerning the origin of PGCs, not easily understandable on the base of traditional knowledge, are pointed out. All those differences can be explained taking into consideration the recent “theory of the endoderm as secondary layer”. That theory allows us to understand that those differences are only apparent, being related to modifications of stages of the consequent embryogeny, overall, to a different amount of yolk in the egg. Eggs very rich in yolk became meroblastic, and the portion of primordial ectomesenchyme destined to give rise to a part of the mesoderm and the PGCs separates early from the part destined to give rise to the rest of the mesoderm and to the digestive endoderm in order to form the vitelline hypoblast lamina. To this lamina, in contrast to the traditional interpretation, a mesodermal, not endodermal, origin must be attributed. With the misunderstanding regarding the origin of this lamina clarified, all the differences about the origin of PGCs disappears. Furthermore, in taxa where PGCs were considered to be of endodermal origin, they too have a mesodermal origin. Considering that a mesodermal origin of PGCs has been demonstrated in all sponges and cnidarians, as well, a unique, mesodermal origin of germinal cells in all pluricellular animals results.

  12. Anomalous origin of the left coronary artery from the right pulmonary artery with intramural aortic trajectory. Clinicosurgical diagnostic implications

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    Edmar Atik

    1999-08-01

    Full Text Available OBJECTIVE: Anomalous origin of the left coronary artery from the right pulmonary artery (AOLCARPA, is a rare entity that is usually associated with other defects. Of the 20 cases of AOLCARPA reported in the literature, 14 (70% had associations. We describe four patients with AOLCARPA without associated defects, but with a peculiar intramural aortic trajectory. METHODS: Fifty-five patients with anomalous origin of the left coronary artery were operated upon at INCOR-FMUSP. Four of the patients had the anomalous origin from the right pulmonary artery (RPA without associated defects but with intramural aortic trajectory. Clinical and laboratory examinations were analyzed, as well as surgical findings. RESULTS: All patients had congestive heart failure (CHF and 3 also had angina pectoris. Two patients had a murmur of mitral regurgitation, signs of myocardial infarction on the ECG and cardiomegaly. The shortening fraction varied from 9% to 23%. The hemodynamic study confirmed the diagnosis of anomalous origin of the coronary artery, but the intramural trajectory and the origin from the RPA were established only at surgery. In 3 patients, the technique of side-to-side anastomosis was performed with a good outcome. One patient, who underwent end-to-side anastomosis, died 6 months after the surgery. CONCLUSION: Association with other defects usually occurs in the AOLCARPA, and the intramural aortic trajectory is difficult to clinically diagnose but easy to surgically correct.

  13. ASSESSMENT OF VERTEBRAL ARTERIES BLOOD FLOW SPECTRAL DOPPLER INDICES IN COMPARISON WITH INTERNAL AND COMMON CAROTID ARTERIES BLOOD FLOW SPECTRAL DOPPLER INDICES

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    H. Mazaher

    2007-05-01

    Full Text Available Vertebrobasilar insufficiency is the cause of cerebrovascular accidents in 20% of cases. There are few reports regarding spectral Doppler indices (SDIs of vertebral arteries (VAs normal blood flow. The objective of this study was to provide basic reference data about SDIs of VAs normal blood flow separately and in comparison with internal carotid arteries (ICAs and common carotid arteries (CCAs normal blood flows SDIs. This cross-sectional study performed on 70 normal patients. Color Doppler sonography (CDS and spectral Doppler sonography (SDS of right and left VAs (RVA and LVA, right and left CCAs (RCCA and LCCA, right and left ICAs (RICA and LICA, were performed. The mean PSV, EDV, and RI values of RVA blood flow were as 41.60 ± 9.6 cm/s, 14.60 ± 3.7 cm/s and 0.65 ± 0.06, and the mean PSV, EDV and RI values of LVA blood flow were as 42.20 ± 10.2 cm/s, 15.20 ± 4.2 cm/s, and 0.64 ± 0.05, respectively. There was not statistically significant difference between the mean PSV, EDV and RI values of RVA and LVA blood flows. The mean PSV and EDV values of VAs blood flows were significantly lower than the values of CCAs and ICCAs blood flows, respectively. The mean RI value of VAs blood flows was significantly lower than the mean RI Value of CCAs blood flows, but there was not statistically significant difference between the mean RI value of VAs blood flows and the mean RI value of ICAs blood flows.

  14. Clinical and radiological outcomes following traumatic Grade 3 and 4 vertebral artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.

    Science.gov (United States)

    Scott, William W; Sharp, Steven; Figueroa, Stephen A; Eastman, Alexander L; Hatchette, Charles V; Madden, Christopher J; Rickert, Kim L

    2015-05-01

    Grade 3 and 4 blunt vertebral artery (VA) injuries may carry a different natural course from that of lower-grade blunt VA injuries. Proper screening, management, and follow-up of these injuries remain controversial. Grade 3 and 4 blunt VA injuries were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral artery injuries from August 2003 to April 2013 was performed, and Grade 3 and 4 blunt VA injuries were identified. Grade 3 injuries were defined as stenosis of the vessel greater than 50% or the development of a pseudoaneurysm, and Grade 4 injuries were defined as complete vessel occlusion. Demographic information, radiographic imaging findings, number of imaging sessions performed per individual, length of radiographic follow-up, radiographic outcome at end of follow-up, treatment(s) provided, and documentation of ischemic stroke or transient ischemic attack were recorded. A total of 79 high-grade (Grade 3 and 4) blunt VA injuries in 67 patients were identified. Fifty-nine patients with 66 high-grade blunt VA injuries were available for follow-up. There were 17 patients with 23 Grade 3 injuries and 42 patients with 43 Grade 4 injuries. The mean follow-up duration was 58 days for Grade 3 and 67 days for Grade 4 blunt VA injuries. Repeat imaging of Grade 3 blunt VA injuries showed that 39% of injuries were radiographically stable, 43% resolved, and 13% improved, while 1 injury radiographically worsened. Repeat imaging of the Grade 4 blunt VA injuries showed that 65% of injuries were radiographically stable (persistent occlusion), 30% improved (recanalization of the vessel), and in 2 cases (5%) the injury resolved. All Grade 3 injuries that were treated were managed with aspirin or clopidogrel alone, as were the majority of Grade 4 injuries. There were 3 cerebral infarctions

  15. Origin of left accessory hepatic artery from the left gastric artery in a ...

    African Journals Online (AJOL)

    We report a case of accessory hepatic artery that arose from the left gastric artery, entered the liver at an independent site from the porta hepatis to supply the left lobe of the liver. Transplantation of such livers with multi vascular pedicles may pose a challenge during anastomosis of these accessory hepatic arteries of the ...

  16. The Surgical Outcome of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery

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    Tasneem Muzaffar

    2014-06-01

    Full Text Available Background:: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a rare congenital anomaly which represents one of the most common causes of myocardial ischemia and infarction in children. This anomaly, if left untreated, results in a very high mortality rate within the first year of life. Yet, immediate surgical correction can lead to excellent results.. Objectives:: The present study aimed to determine the surgical outcome of ALCAPA.. Methods:: This study was conducted on 53 patients with ALCAPA operated from January 2005 to December 2012. Surgical repair was carried out as soon as the diagnosis was made. Surgery was thus undertaken on an urgent basis (within 48 hours in the patients with congestive heart failure or critical clinical status and on a semi- elective basis (within a few days in the remaining children. Operations for all the patients were performed through a median sternotomy using established standard cardiopulmonary bypass technique. Grouped variables were compared using chi-square test with Yates’ correction. Besides, McNemar’s test was used to assess the relationship between preoperative ejection fraction and mitral incompetence. All the analyses were performed using the SPSS statistical software, version 11.5 (SPSS Inc., Chicago, IL.. Results:: The patients’ median age at presentation was 4 months. The mean preoperative ejection fraction was 36.5%. The results showed a significant relationship between age at presentation and impairment of ejection fraction (P < 0.001. At first, 23% of our patients presented with ejection fraction < 35%. However, 6 months after the operation, the ejection fraction improved to a mean of 53.07% (SD = 8.5 ranging from 38 - 66%. There were 5 postoperative hospital deaths with an overall mortality rate of 9.6%.. Conclusions:: Excellent results with desirable long-term outcomes can be achieved in the infants with ALCAPA using coronary artery implantation

  17. Origin of dental occlusion in tetrapods: signal for terrestrial vertebrate evolution?

    Science.gov (United States)

    Reisz, Robert R

    2006-05-15

    Evolutionary changes of the dentition in tetrapods can be associated with major events in the history of terrestrial vertebrates. Dental occlusion, the process by which teeth from the upper jaw come in contact with those in the lower jaw, appears first in the fossil record in amniotes and their close relatives near the Permo-Carboniferous boundary approximately 300 million years ago. This evolutionary innovation permitted a dramatic increase in the level of oral processing of food in these early tetrapods, and has been generally associated with herbivory. Whereas herbivory in extinct vertebrates is based on circumstantial evidence, dental occlusion provides direct evidence about feeding strategies because jaw movements can be reconstructed from the wear patterns of the teeth. Examination of the evolution of dental occlusion in Paleozoic tetrapods within a phylogenetic framework reveals that this innovation developed independently in several lineages of amniotes, and is represented by a wide range of dental and mandibular morphologies. Dental occlusion also developed within diadectomorphs, the sister taxon of amniotes. The independent, multiple acquisition of this feeding strategy represents an important signal in the evolution of complex terrestrial vertebrate communities, and the first steps in the profound changes in the pattern of trophic interactions in terrestrial ecosystems. (c) 2006 Wiley-Liss, Inc.

  18. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

    Directory of Open Access Journals (Sweden)

    Venkat Gangadharan MD

    2017-01-01

    Full Text Available A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

  19. Origin of axial prestretch and residual stress in arteries.

    Science.gov (United States)

    Cardamone, L; Valentín, A; Eberth, J F; Humphrey, J D

    2009-12-01

    The structural protein elastin endows large arteries with unique biological functionality and mechanical integrity, hence its disorganization, fragmentation, or degradation can have important consequences on the progression and treatment of vascular diseases. There is, therefore, a need in arterial mechanics to move from materially uniform, phenomenological, constitutive relations for the wall to those that account for separate contributions of the primary structural constituents: elastin, fibrillar collagens, smooth muscle, and amorphous matrix. In this paper, we employ a recently proposed constrained mixture model of the arterial wall and show that prestretched elastin contributes significantly to both the retraction of arteries that is observed upon transection and the opening angle that follows the introduction of a radial cut in an unloaded segment. We also show that the transmural distributions of elastin and collagen, compressive stiffness of collagen, and smooth muscle tone play complementary roles. Axial prestresses and residual stresses in arteries contribute to the homeostatic state of stress in vivo as well as adaptations to perturbed loads, disease, or injury. Understanding better the development of and changes in wall stress due to individual extracellular matrix constituents thus promises to provide considerable clinically important insight into arterial health and disease.

  20. Origin of Axial Prestretch and Residual Stress in Arteries*

    Science.gov (United States)

    Cardamone, L.; Valentin, A.; Eberth, J.F.; Humphrey, J.D.

    2009-01-01

    The structural protein elastin endows large arteries with unique biological functionality and mechanical integrity, hence its disorganization, fragmentation, or degradation can have important consequences on the progression and treatment of vascular diseases. There is, therefore, a need in arterial mechanics to move from materially uniform, phenomenological, constitutive relations for the wall to those that account for separate contributions of the primary structural constituents: elastin, fibrillar collagens, smooth muscle, and amorphous matrix. In this paper, we employ a recently proposed constrained mixture model of the arterial wall and show that prestretched elastin contributes significantly to both the retraction of arteries that is observed upon transection and the opening angle that follows the introduction of a radial cut in an unloaded segment. We also show that the transmural distributions of elastin and collagen, compressive stiffness of collagen, and smooth muscle tone play complementary roles. Axial prestresses and residual stresses in arteries contribute to the homeostatic state of stress in vivo as well as adaptations to perturbed loads, disease, or injury. Understanding better the development of and changes in wall stress due to individual extracellular matrix constituents thus promises to provide considerable clinically important insight into arterial health and disease. PMID:19123012

  1. The diagnostic accuracy of magnetic resonance angiography for blunt vertebral artery injury detection in trauma patients: A systematic review and meta-analysis.

    Science.gov (United States)

    Karagiorgas, Georgios P; Brotis, Alexandros G; Giannis, Theofanis; Rountas, Christos D; Vassiou, Katerina G; Fountas, Kostas N; Kapsalaki, Eftychia Z

    2017-09-01

    The role of magnetic resonance angiography (MRA) in the evaluation of patients with blunt vertebral artery has not been fully established. Our aim is to define the diagnostic accuracy of MRA in comparison to digital subtraction angiography (DSA) for the detection of blunt vertebral artery injury in trauma patients. A computer-assisted literature search of the PubMed, Scopus, Highwire, Web of Science, and LILACS was conducted, in order to identify studies reporting on the sensitivity and specificity of MRA in comparison to DSA for the detection of blunt vertebral artery injury in trauma patients. The Database search retrieved 91 studies. Five studies fulfilled our eligibility criteria. Two authors assessed the risk of bias and applicability concerns using QUADAS-2. Two-by-two contingency tables were constructed on a per-vessel level. Heterogeneity was tested by the statistical significance of Cochran's Q, and was quantified by the Higgins's I2 metric. The pooled estimates of sensitivity and specificity for blunt vertebral artery injury detection with MRA in comparison to DSA were calculated based on the bivariate model. The meta-analysis was supplemented by subgroup and sensitivity analysis, as well as analysis for publication bias. There was significant clinical heterogeneity in the targeted population, inclusion criteria, and MRA related parameters. The reporting bias and applicability concerns were moderate and low, respectively. In the overall analysis, the sensitivity ranged from 25% to 85%, while the specificity varied from 65% to 99%, across studies. According to the bivariate model, the pooled sensitivity and specificity of MRA in the evaluation of patients with blunt vertebral artery was as high as 55% (95% CI 32.1%-76.7%), and 91% (95% CI 66.3%-98.2%), respectively. Subgroup analysis in terms of MRA sequence sensitivity of phase, the contrasted MRA (75% [95% CI 43%-92%]) seemed to be superior to the TOF MRA (46% [95%CI 20%-74%]). The addition of contrast

  2. Origin and loss of nested LRRTM/α-catenin genes during vertebrate evolution.

    Directory of Open Access Journals (Sweden)

    Pavel Uvarov

    Full Text Available Leucine-rich repeat transmembrane neuronal proteins (LRRTMs form in mammals a family of four postsynaptic adhesion proteins, which have been shown to bind neurexins and heparan sulphate proteoglycan (HSPG glypican on the presynaptic side. Mutations in the genes encoding LRRTMs and neurexins are implicated in human cognitive disorders such as schizophrenia and autism. Our analysis shows that in most jawed vertebrates, lrrtm1, lrrtm2, and lrrtm3 genes are nested on opposite strands of large conserved intron of α-catenin genes ctnna2, ctnna1, and ctnna3, respectively. No lrrtm genes could be found in tunicates or lancelets, while two lrrtm genes are found in the lamprey genome, one of which is adjacent to a single ctnna homolog. Based on similar highly positive net charge of lamprey LRRTMs and the HSPG-binding LRRTM3 and LRRTM4 proteins, we speculate that the ancestral LRRTM might have bound HSPG before acquiring neurexins as binding partners. Our model suggests that lrrtm gene translocated into the large ctnna intron in early vertebrates, and that subsequent duplications resulted in three lrrtm/ctnna gene pairs present in most jawed vertebrates. However, we detected three prominent exceptions: (1 the lrrtm3/ctnna3 gene structure is absent in the ray-finned fish genomes, (2 the genomes of clawed frogs contain ctnna1 but lack the corresponding nested (lrrtm2 gene, and (3 contain lrrtm3 gene in the syntenic position but lack the corresponding host (ctnna3 gene. We identified several other protein-coding nested gene structures of which either the host or the nested gene has presumably been lost in the frog or chicken lineages. Interestingly, majority of these nested genes comprise LRR domains.

  3. Estudo anatômico do trajeto da artéria vertebral na coluna cervical inferior humana Anatomical study of the vertebral artery path in human lower cervical spine

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    Ben Hur Junitiro Kajimoto

    2007-01-01

    Full Text Available O aumento da utilização de novas técnicas e materiais de síntese para o tratamento cirúrgico de afecções da coluna cervical baixa foi acompanhado da crescente preocupação em relação às complicações que podem ocorrer. A técnica de fixação transpedicular, amplamente utilizada para os outros níveis da coluna vertebral, quando realizada na coluna cervical, apesar de conferir maior estabilidade quando comparada a outras técnicas, pode cursar com complicações graves como lesão da artéria vertebral, lesão de raiz nervosa, além de lesão da articulação facetária. A vértebra C7, no entanto, é considerada mais segura para a realização de tal procedimento, já que, na grande maioria das pessoas, segundo os estudos anatômicos disponíveis, esta não possui a artéria vertebral dentro de seu forame transverso, pois este vaso irá penetrar tal estrutura apenas na vértebra C6. Como hoje existem apenas estudos de imagem para avaliação do trajeto desta artéria e suas variações anatômicas, realizamos este estudo anatômico dissecando 40 artérias vertebrais de cadáveres para avaliar a incidência das variações anatômicas. Encontramos 3 casos onde a artéria vertebral penetrou o forame transverso já em C7 (7,5%, o que aumentaria o risco de uma técnica transpedicular neste nível. O restante das peças anatômicas possuíam anatomia habitual.The increasing use of new techniques and materials for surgical treatment of lower cervical spine conditions has come along with an increasing concern regarding potential complications that might occur. The transpedicular fixation technique, frequently used in other spine levels, is used on the cervical spine, while providing more stability than other techniques, it may cause serious complications such as vertebral artery injury, nervous root injury, or facet joint injuries. However, the C7 vertebra is considered safer for performing this procedure, since, in the vast majority of

  4. The Origin and Diversity of Cpt1 Genes in Vertebrate Species.

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    Lopes-Marques, Mónica; Delgado, Inês L S; Ruivo, Raquel; Torres, Yan; Sainath, Sri Bhashyam; Rocha, Eduardo; Cunha, Isabel; Santos, Miguel M; Castro, L Filipe C

    2015-01-01

    The Carnitine palmitoyltransferase I (Cpt1) gene family plays a crucial role in energy homeostasis since it is required for the occurrence of fatty acid β-oxidation in the mitochondria. The exact gene repertoire in different vertebrate lineages is variable. Presently, four genes are documented: Cpt1a, also known as Cpt1a1, Cpt1a2; Cpt1b and Cpt1c. The later is considered a mammalian innovation resulting from a gene duplication event in the ancestor of mammals, after the divergence of sauropsids. In contrast, Cpt1a2 has been found exclusively in teleosts. Here, we reassess the overall evolutionary relationships of Cpt1 genes using a combination of approaches, including the survey of the gene repertoire in basal gnathostome lineages. Through molecular phylogenetics and synteny studies, we find that Cpt1c is most likely a rapidly evolving orthologue of Cpt1a2. Thus, Cpt1c is present in other lineages such as cartilaginous fish, reptiles, amphibians and the coelacanth. We show that genome duplications (2R) and variable rates of sequence evolution contribute to the history of Cpt1 genes in vertebrates. Finally, we propose that loss of Cpt1b is the likely cause for the unusual energy metabolism of elasmobranch.

  5. The Origin and Diversity of Cpt1 Genes in Vertebrate Species.

    Directory of Open Access Journals (Sweden)

    Mónica Lopes-Marques

    Full Text Available The Carnitine palmitoyltransferase I (Cpt1 gene family plays a crucial role in energy homeostasis since it is required for the occurrence of fatty acid β-oxidation in the mitochondria. The exact gene repertoire in different vertebrate lineages is variable. Presently, four genes are documented: Cpt1a, also known as Cpt1a1, Cpt1a2; Cpt1b and Cpt1c. The later is considered a mammalian innovation resulting from a gene duplication event in the ancestor of mammals, after the divergence of sauropsids. In contrast, Cpt1a2 has been found exclusively in teleosts. Here, we reassess the overall evolutionary relationships of Cpt1 genes using a combination of approaches, including the survey of the gene repertoire in basal gnathostome lineages. Through molecular phylogenetics and synteny studies, we find that Cpt1c is most likely a rapidly evolving orthologue of Cpt1a2. Thus, Cpt1c is present in other lineages such as cartilaginous fish, reptiles, amphibians and the coelacanth. We show that genome duplications (2R and variable rates of sequence evolution contribute to the history of Cpt1 genes in vertebrates. Finally, we propose that loss of Cpt1b is the likely cause for the unusual energy metabolism of elasmobranch.

  6. Posterior Circulation Moyamoya Disease versus Primitive Vertebral-Basilar Artery System Moyamoya Disease: New Classification of Moyamoya Disease from the Perspective of Embryology.

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    Tan, Cunxin; Duan, Ran; Ye, Xun; Zhang, Dong; Wang, Rong

    2016-12-01

    Moyamoya disease (MMD) is a chronic cerebrovascular disorder with little known etiology. We aim to propose a new classification system for MMD from the perspective of embryology. MMD patients' digital subtraction angiograms were retrospectively analyzed. Every angiogram was analyzed to find the abnormal vessels and from which part of the posterior cerebral artery (PCA) the lesions begin. In 262 MMD cases, 32 pediatric patients had PCA involvement, of which 17 were male and 15 were female; 68 adults had PCA involvement, of which 33 were male and 35 were female. The initially affected part of the PCA was compared between sexes and between pediatric and adult patients, and the findings are not statistically significant (P = 0.233, P = 0.855, P = 0.343, respectively). However, of the 100 cases with PCA involvement, only 4 had the lesions begin from the first part of the PCA, and all of the 4 cases had the basilar artery lesions. All the other 96 cases had the lesions begin from the second part of the PCA or from the posterior communication artery, which is derived from the caudal ramus of the primitive intracarotid artery, leaving the first part of the PCA and basilar artery excluded from affection. MMD should be classified into primitive intracarotid artery system-involved type and primitive vertebral basilar artery system-involved type. The reason that the vertebral basilar artery is so rarely involved in MMD might be because of its late development in the brain. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

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    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  8. Food-Nonfood Discrimination in Ancestral Vertebrates: Gamete Cannibalism and the Origin of the Adaptive Immune System.

    Science.gov (United States)

    Corcos, D

    2015-11-01

    Adaptive immunity is a complex system that appeared twice in vertebrates (in gnathostomes and in jawless fish) although it is not required for invertebrate defence. The adaptive immune system is tightly associated with self-non-self discrimination, and it is now clear that this interplay is not limited to the prevention of autoreactivity. Micro-organisms are usually considered for their pathogenicity or symbiotic ability, but, for most small metazoans, they mainly constitute food. Vertebrates are characterized by feeding by predation on larger preys, when compared to their ancestors who were filter feeders and ate micro-organisms. Predation gives a strong selective advantage, not only due to the availability of new food resources but also by the ability to eliminate competitors for environmental resources (intraguild predation (IGP)). Unlike size-structured IGP, intraspecific predation of juveniles, zygotes or gametes can be detrimental for species fitness in some circumstances. The ability of individuals to recognize highly polymorphic molecules on the surface of gametes present in the plankton and so distinguish self versus non-self gametes might have constituted a strong selective advantage in intraspecific competition. Here, I propose the theory that the capacity to rearrange receptors has been selected in ancestral vertebrates as a consequence of this strong need for discriminating between hetero-cannibalism versus filial cannibalism. This evolutionary origin sheds light on presently unexplained features of the immune system, including the existence of regulatory T cells and of non-pathogenic natural autoimmunity. © 2015 The Foundation for the Scandinavian Journal of Immunology.

  9. Anatomic variation in the origin of the main renal arteries: spiral CTA evaluation

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    Beregi, J.P.; Willoteaux, S.; Remy-Jardin, M. [Department of Vascular Radiology, Hopital Cardiologique, 59 - Lille (France); Mauroy, B.; Francke, J.P. [Laboratoire d`Anatomie, Univ. de Lille (France); Mounier-Vehier, C. [Department of Hypertension and Internal Medicine, Hopital Cardiologique, Lille (France)

    1999-09-01

    The aim of this study was to provide quantitative data on the origin and trajectory of the main renal arteries using spiral CT angiography and arteriography. Normal renal artery anatomy was assessed on spiral CT angiography (axial transverse sections and shaded-surface-display reconstructions) in 100 patients referred for renal arteriography who had no significant renal artery stenosis. Two hundred major renal arteries were studied. The vast majority of right (88 %) and left (87 %) renal arteries originated between the lower third of the first lumbar vertebra and the lower border of the second lumbar vertebra. In 50 patients both ostia were at the same level; in the remaining 50 patients, the right ostium was located above the left in 37 patients. On the right, the angle of origin varied from -10 to + 55 (mean + 24 ). On the left, the angle of origin varied from + 30 to -55 (mean -11 ). Spiral CT angiography provides additional anatomic data, notably regarding the angle of origin of the renal arteries, that is potentially useful for planning interventional procedures. (orig.) With 4 figs., 19 refs.

  10. Devonian arthrodire embryos and the origin of internal fertilization in vertebrates.

    Science.gov (United States)

    Long, John A; Trinajstic, Kate; Johanson, Zerina

    2009-02-26

    Evidence of reproductive biology is extremely rare in the fossil record. Recently the first known embryos were discovered within the Placodermi, an extinct class of armoured fish, indicating a viviparous mode of reproduction in a vertebrate group outside the crown-group Gnathostomata (Chondrichthyes and Osteichthyes). These embryos were found in ptyctodontids, a small group of placoderms phylogenetically basal to the largest group, the Arthrodira. Here we report the discovery of embryos in the Arthrodira inside specimens of Incisoscutum ritchiei from the Upper Devonian Gogo Formation of Western Australia (approximately 380 million years ago), providing the first evidence, to our knowledge, for reproduction using internal fertilization in this diverse group. We show that Incisoscutum and some phyllolepid arthrodires possessed pelvic girdles with long basipterygia that articulated distally with an additional cartilaginous element or series, as in chondrichthyans, indicating that the pelvic fin was used in copulation. As homology between similar pelvic girdle skeletal structures in ptyctodontids, arthrodires and chondrichthyans is difficult to reconcile in the light of current phylogenies of lower gnathostomes, we explain these similarities as being most likely due to convergence (homoplasy). These new finds confirm that reproduction by internal fertilization and viviparity was much more widespread in the earliest gnathostomes than had been previously appreciated.

  11. Predictive value of vertebral artery extracranial color-coded duplex sonography for ischemic stroke-related vertigo

    Directory of Open Access Journals (Sweden)

    Li-Min Liou

    2013-12-01

    Full Text Available Vertigo can be a major presentation of posterior circulation stroke and can be easily misdiagnosed because of its complicated presentation. We thus prospectively assessed the predictive value of vertebral artery extracranial color-coded duplex sonography (ECCS for the prediction of ischemic stroke-related vertigo. The inclusion criteria were: (1 a sensation of whirling (vertigo; (2 intractable vertigo for more than 1 hour despite appropriate treatment; and (3 those who could complete cranial magnetic resonance imaging (MRI and vertebral artery (V2 segment ECCS studies. Eventually, 76 consecutive participants with vertigo were enrolled from Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan between August 2010 and August 2011. Demographic data, neurological symptoms, neurologic examinations, and V2 ECCS were assessed. We chose the parameters of peak systolic velocity (PSV, end diastolic velocity (EDV, PSV/EDV, mean velocity (MV, resistance index (RI, and pulsatility index (PI to represent the hemodynamics. Values from both sides of V2 segments were averaged. We then calculated the average RI (aRI, average PI (aPI, average PSV (aPSV/EDV, and average (aMV. Axial and coronal diffusion-weighted MRI findings determined the existence of acute ischemic stroke. We grouped and analyzed participants in two ways (way I and way II analyses based on the diffusion-weighted MRI findings (to determine whether there was acute stroke and neurological examinations. Using way I analysis, the “MRI (+” group had significantly higher impedance (aRI, aPI, and aPSV/EDV ratio and lower velocity (aPSV, aEDV, and aMV(PSV + EDV/2, compared to the “MRI (–” group. The cutoff value/sensitivity/specificity of aPSV, aEDV, aMV, aPI, aRI, and aPSV/EDV between the MRI (+ and MRI (– groups were 41.15/61.5/66.0 (p = 0.0101, 14.55/69.2/72.0 (p = 0.0003, 29.10/92.1/38.0 (p = 0.0013, 1.07/76.9/64.0 (p = 0.0066, 0.62/76.9/64.0 (p = 0.0076, and 2

  12. Understanding the Course of Vertebral Artery at Craniovertebral Junction in Occipital Assimilation of Atlas: Made Simplified Using Conventional Angiography.

    Science.gov (United States)

    Jagetia, Anita; Mewda, Tushit; Bishnoi, Ishu; Bhutte, Manoj; Singh, Hukum; Srivastava, A K; Singh, Daljit

    2017-04-01

    Introduction Preoperative assessment of vertebral artery (VA) is important to avoid its injury during surgery at craniovertebral junction (CVJ). The main concern is the course of third segment of VA (V3) while performing instrumentation at CVJ, that is, segment of VA from its course through transverse foramen of C2 to its course along the posterior arch of C1. This segment of VA includes its passage through C1 transverse foramen as well. This observational study was done to analyze the course, curvature, and termination of VA in patients with occipital assimilation of atlas at CVJ, a complex congenital anomaly, and compared with the normal course for better understanding especially by young neurosurgeons and spine surgeons. Materials and Method This is an observational study that included patients with occipitalized C1 with or without associated anomalies. Out of 30 patients of CVJ anomalies, 16 patients had occipitalized atlas. Digital subtraction angiography was done in all cases. It was done by selectively catheterizing the VA using standard Seldinger's technique and both anteroposterior and lateral projections were taken. Results The course of VA was not identical on either side in any individual. It was lengthened and tortuous in all patients. Different types of anomalous course were encountered like bypassing transverse foramen of C1, close relation with C1-2 facet joints, variable course along the posterior arch of C1, abnormal termination and fenestration of VA. Conclusion Craniovertebral junction anomalies are not only bony or neural, but are vascular too. Complex CVJ anomalies are associated with higher incidence of anomalous course of the VA, an important surgical consideration.

  13. The right intercostobronchial trunk: anatomical study in respect of posterior intercostal artery origin and its clinical application.

    Science.gov (United States)

    Kocbek, Lidija; Rakuša, Mateja

    2018-01-01

    The right bronchial artery usually arises from the descending thoracic aorta as a common trunk with the right intercostal artery and forms the right intercostobronchial trunk. Both, the third right posterior intercostal artery and the right intercostobronchial trunk, are described as the most constant vessels. The focus of the study was to determine the characteristics of the right intercostobronchial trunk regarding the origins of the posterior intercostal arteries from the thoracic aorta. Posterior intercostal arteries and the right bronchial arteries were dissected in 43 human cadavers, preserved after Thiel's embalming method with intraarterial infusion of red colored latex. Postmortem examination gave valued information on the right intercostobronchial trunk present in 58% of cases. The right intercostobronchial trunk was mapped and new classification regarding the origin of the posterior intercostal arteries from the thoracic aorta suggested type A, B and C, the latter ones into subtypes 1 and 2. Type A was proportional to the origin level of the PIA and its corresponding intercostal space. Size of outer diameter at the origin did not indicate the right bronchial artery branch. In subtype 2 of type B the proximal posterior intercostal artery diameter that gave off right bronchial artery was thicker than distal one. The right bronchial artery originates from the second to the fifth posterior intercostal artery forming the right intercostobronchial trunk. Various origin and types of origin, diameter and course of the right intercostobronchial trunk described and analyzed in the study offer valuable information on the procedures involving the right intercostobronchial trunk.

  14. Anomalous Origin of One Pulmonary Artery From the Ascending Aorta: From Diagnosis to Treatment in Angola.

    Science.gov (United States)

    Manuel, Valdano; Sousa-Uva, Miguel; Morais, Humberto; Magalhães, Manuel P; Pedro, Albino; Miguel, Gade; Nunes, Maria A S; Gamboa, Sebastiana; Júnior, António P F

    2015-10-01

    Anomalous origin of one pulmonary artery is a rare congenital heart disease in which one pulmonary artery branch originates from the ascending aorta. To describe the experience of a cardiothoracic center in an African country to repair anomalous origin of one pulmonary artery in the context of Portugal-Angola collaboration. Between March 2011 and March 2015, four consecutive patients with anomalous origin of pulmonary artery branch underwent surgical correction. The mean age was 1.6 months. The mean weight was 4 kg. All had right pulmonary artery branch originating from the ascending aorta. All patients underwent direct implantation of right pulmonary branch to main pulmonary artery. Two patents had patent ductus arteriosus and one had atrial septal defect. Two patients had pulmonary hypertension. There was no registration of death. The mean cardiopulmonary bypass time was 75.5 ± 4.5 minutes, mean aortic cross-clamping time was 40 ± 5.6 minutes, and mean duration of the postoperative intensive care unit stay was 6.8 ± 5.7 days. At discharge, one patient had residual gradient of 25 mm Hg, the remainder had no significant gradient. The mean follow-up time was 11 months (5-28 months). One week after discharge, one patient presented operative wound dehiscence. At the last follow-up, all patients were alive, and no significant residual gradient or stenosis at site of anastomosis was observed. No reintervention was required. Anomalous origin of one pulmonary artery is a rare but potentially treatable lesion if operated early in life. Direct implantation was a good technique with good short-term results. © The Author(s) 2015.

  15. The Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA: a Case Series and Brief Review

    Directory of Open Access Journals (Sweden)

    Aliasghar Moeinipour

    2016-02-01

    Full Text Available Background Anomalous left coronary artery from the pulmonary artery (ALCAPA is a rare congenital cardiovascular defect that occurs in approximately 1/300 000 live births or 0.5% of children with congenital heart disease. There are two types of ALCAPA syndrome: the infant type and the adult type. The most infants experience myocardial infarction and congestive heart failure, and approximately 90% die within the first year of life; also, without early surgical intervention they have a dismal prognosis. Materials and Methods We report 3- year experiences from January 2013 to January 2016 of Imam Reza Hospital center (a tertiary referral hospital North East of Iran that consist of all patients with ALCAPA syndrome. Results The Takeuchi procedure, were successfully performed in five children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA. There was no death and significant mitral regurgitation postoperative (n=0 in this short study. All of patients (n=5 had evidence of improving ischemic myocardium status by increasing of ejection fraction and regional wall motion of left ventricular in follow up echocardiography. Conclusion The only cure treatment for ALCAPA syndrome is surgical intervention that needs to be performed immediately after diagnosis to prevent myocardial infarction and chronic heart failure. Today, establishing a system with two coronary arteries is the goal in definitive surgical repair. The Takeuchi procedure is a prefer method to establish a two-coronary repair for ALCAPA.

  16. Superior rectal artery origin from the median sacral artery--angiographic appearance, developmental anatomy, and clinical implications.

    Science.gov (United States)

    Pearl, Monica S; Gest, Thomas R; Gailloud, Philippe

    2014-09-01

    Two angiographic observations of significant rectal vascularization by branches originating from the median sacral artery (MSA) are reported. In the first case, the MSA provided a complete superior rectal trunk, with left and right branches, while in the second, the MSA only contributed superior rectal branches to the right side of the rectum, the left side being supplied by left internal iliac branches. The angiographic appearance, developmental anatomy, and clinical significance of these variants are discussed. © 2014 Wiley Periodicals, Inc.

  17. [Embolism of the humeral artery originating in a thrombosed axillo-femoral bypass].

    Science.gov (United States)

    Barba, A; Escribano, J V; García-Alfageme, A

    1992-01-01

    A case of a patient, with acute arterial ischemia at the upper limb is reported. On this case, ischemia was caused by humeral arterial embolism. The embolic origin was focused on the proximal end of a thrombosed axillofemoral bypass. After a rude manipulation during surgical procedure, part of the thrombus, following the sanguineous current, occluded the humeral artery. Patient underwent an emergent surgery. Posterior course was good. Histology showed a re-epithelialized, ancient thrombus. Cardiologic studies and angiography showed no others embolic focuses.

  18. Anomalous origin of the right coronary artery from the pulmonary artery: an autopsied sudden death case with severe atherosclerotic disease of the left coronary artery.

    Science.gov (United States)

    Nagai, T; Mukai, T; Takahashi, S; Takada, A; Saito, K; Harada, K; Mori, S; Abe, N

    2014-03-01

    Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare anomaly. It may contribute to myocardial ischemia or sudden death, although the lesion is usually asymptomatic. We report a sudden death case of a 58-year-old man with ARCAPA coexisting with severe atherosclerotic coronary artery disease. He had been healthy until he complained of chest pain, several days before death, despite the discovery of heart murmur in childhood and suspicion of valvular heart disease. The autopsy revealed not only typical findings of the right coronary anomaly with well-developed collateral circulations but also severe atherosclerotic lesions of the left coronary artery, and ischemic change of the myocardium in the left and right coronary arterial perfusion territory. In addition to the "coronary steal" phenomenon primarily caused by ARCAPA, the reduced flow of both coronary arteries and further increase of "coronary steal" due to atherosclerotic obstructive coronary disease might have contributed to the patient's death. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Anomalous origin of coronary artery: the role of multislice CT Angiography: a case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Rabelo, Daniel Rocha; Barros, Marcio Vinicius Lins; Nunes, Maria do Carmo Pereira; Siqueira, Maria Helena Albernaz, E-mail: marciovlbarros@uol.com.br [Hospital Mater Dei, Belo Horizonte, MG (Brazil)

    2012-07-15

    Anomalous origin of coronary arteries is a relatively rare entity and can present different clinical forms. Recently, CT angiography of the coronary arteries have demonstrated an important role in the diagnosis and management of these anomalies. We present the case of a young female without significant comorbidities who presented with cardiopulmonary arrest, being revived by a team of customer service mobile emergency. After completion of multislice CT angiography of the coronary arteries was observed anomalous origin of left main coronary artery in the right coronary artery, no signs of extrinsic compression. Patient received a defibrillator and had an uneventful follow-up performed. Multislice CT angiography is minimally invasive diagnostic methods to detect the origin and trajectory of the coronary arteries, allowing an alternative to cardiac catheterization for evaluation of patients with anomalous origin of coronary arteries. (author)

  20. A rare complication of a unilateral vertebral artery occlusion, which resulted in a basilar emboli after a C5-C6 bifacet dislocation in a professional rugby player: case study.

    Science.gov (United States)

    Davies, Simon R

    2011-03-01

    Vertebral artery damage after cervical fracture and especially cervical dislocations is a recognized phenomenon. The incidence of significant intracranial neurology after unilateral vertebral damage is extremely rare, and to our knowledge, no such injury has been sustained while playing sport. To describe a rare vascular complication of a bifacet C5-C6 dislocation. Case report and clinical discussion. We present a 28-year old white man who was a professional rugby player. He sustained a hyperflexion injury while playing scrum half in a recent league match, which resulted in a C5-C6 dislocation, diagnosed clinically and with a plain radiograph. The patient on admission had complete neurologic loss below C6. The patient underwent immediate computed tomography and magnetic resonance imaging (MRI) scans that revealed a 50% displacement of C5 on C6 with a complete unifacet dislocation and the other facet partially dislocated. The MRI revealed signal changes in the cord at the C5-C6 level and an intimal tear in the left vertebral artery. The decision was taken to reduce the dislocation when medically stable. A few hours after injury, after an episode of vomiting, the patient sustained a respiratory arrest owing to the embolization of a clot from the left vertebral artery into the basilar artery. Despite rapid embolectomy and subsequent permanent left vertebral artery occlusion, the patient sustained multiple infarcts in the cerebellar, thalamic, occipital, and pontine regions of the brain that eventually proved fatal. This case shows a rare complication of unilateral vertebral artery occlusion. Despite early identification of a basilar infarct and a successful embolectomy, intracranial infarction occurred. Although there is no guideline for the treatment of vertebral artery damage, early reduction and anticoagulation may reduce the risk of cerebral infarction. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Reconstructive endovascular treatment of vertebral artery dissecting aneurysms with the Low-profile Visualized Intraluminal Support (LVIS) device.

    Science.gov (United States)

    Wang, Chuan-Chuan; Fang, Yi-Bin; Zhang, Ping; Zhu, Xuan; Hong, Bo; Xu, Yi; Liu, Jian-Min; Huang, Qing-Hai

    2017-01-01

    The Low-profile Visualized Intraluminal Support (LVIS) device is a new generation of self-expanding braided stent recently introduced in China for stent assisted coiling of intracranial aneurysms. The aim of our study is to evaluate the feasibility, safety, and efficacy of the LVIS device in reconstructive treatment of vertebral artery dissecting aneurysms (VADAs). We retrospectively reviewed the neurointerventional database of our institution from June 2014 to May 2016. Patients who underwent endovascular treatment of VADAs with LVIS stents were included in this study. Clinical presentation, aneurysmal characteristics, technical feasibility, procedural complications, and angiographic and clinical follow-up results were evaluated. 38 patients with VADAs who underwent treatment with LVIS stent were identified, including 3 ruptured VADAs. All VADAs were successfully treated with reconstructive techniques including the stent-assisted coiling (n = 34) and stenting only (n = 4). Post-procedural complications developed in 3 patients (7.9%) including two small brainstem infarctions and one delayed thromboembolic event. Complications resulted in one case of minor permanent morbidity (2.6%). There was no procedure-related mortality. The follow-up angiogram was available in 30 patients at an average of 8.3 months (range, 2 to 30 months), which revealed complete occlusion in 23 patients (76.7%), residual neck in five patients (16.7%), and residual sac in two patients (6.7%). The follow-up of 25 aneurysms with incomplete immediate occlusion revealed 22 aneurysms (88%) with improvement in the Raymond class. One aneurysm (3.3%) showed recanalization and required retreatment. Clinical followed-up at 5-28 months (mean 14.1 months) was achieved in 36 patients because two patients died of pancreatic cancer and basal ganglia hemorrhage, respectively. No new neurologic deterioration or aneurysm (re)bleeding was observed. Our preliminary experience with reconstruction of VADAs with the

  2. Molecular evidence for precambrian origin of amelogenin, the major protein of vertebrate enamel.

    Science.gov (United States)

    Delgado, S; Casane, D; Bonnaud, L; Laurin, M; Sire, J Y; Girondot, M

    2001-12-01

    Although molecular dating of cladogenetic events is possible, no molecular method has been described to date the acquisition of various tissues. Taking into account the specificity of the major protein in enamel in formation (amelogenin), we were able to develop such a method for enamel. Indeed, because the amelogenin protein is exclusively involved in enamel formation and mineralization and because it lacks pleiotropic effects, this protein is a good candidate to estimate the date of acquisition of this highly mineralized tissue. We searched DNA banks for similarities between the amelogenin sequence and other sequences. Similarities were found only to exon 2 of SPARC (osteonectin) in two protostomians and in eight deuterostomians, and to exon 2 of three SPARC-related deuterostomian genes (SC1, hevin, and QR1). The other amelogenin exons did not reveal significant similarities to other sequences. In these proteins, exon 2 mainly encodes the peptide signal that plays the essential role in enabling the protein to be ultimately localized in the extracellular matrix. We tested the significance of the exon 2 similarities. The observed values were always significantly higher than the expected randomly generated similarities. This demonstrates a common evolutionary origin of this exon. The phylogenetic analyses of exon 2 sequences indicated that exon 2 was duplicated to amelogenin from an ancestral SPARC sequence in the deuterostomian lineage before the duplication of deuterostomian SPARC and SC1/hevin/QR1. We were able to date the origin of the latter duplication at approximately 630 MYA. Therefore, amelogenin exon 2 was acquired before this date, in the Proterozoic, long before the so-called "Cambrian explosion," the sudden appearance of several bilateralian phyla in the fossil record at the Proterozoic-Phanerozoic transition. This sudden appearance has been often suggested to reflect intensive cladogenesis during this period. However, molecular dating of protostomian

  3. Right-sided aortic arch with anomalous origin of the left subclavian artery: Case report

    Directory of Open Access Journals (Sweden)

    Vučurević Goran

    2011-01-01

    Full Text Available Introduction. A right-sided aortic arch is a rare congenital defect of the aorta with incidence of 0.05% to 0.1% reported in published series. Usually it is associated with congenital heart anomalies and esophageal and tracheal compression symptoms. We present a case of a right-sided aortic arch of anomalous left subclavian artery origin, accidentally revealed during multislice CT (MSCT supraaortic branches angiography. Case Outline. A 53-year-old female patient was examined at the Outpatients’ Unit of the Vascular Surgery University Clinic for vertigo, occasional dizziness and difficulty with swallowing. Physical examination revealed a murmur of the left supraclavicular space, with 15 mmHg lower rate of arterial tension on the left arm. Ultrasound of carotid arteries revealed 60% stenosis of the left subclavian artery and bilateral internal carotid artery elongation. MSCT angiography revealed a right-sided aortic arch with aberrant separation of the left subclavian artery that was narrowed 50%, while internal carotid arteries were marginally elongated. There was no need for surgical treatment or percutaneous interventions, so that conservative treatment was indicated. Conclusion. A right-sided aortic arch is a very rare anomaly of the location and branching of the aorta. Multislice CT angiography is of great importance in the diagnostics of this rare disease.

  4. Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery in a Patient with Ascending Aortic Aneurysm

    OpenAIRE

    Ufuk Gürkan; Yiğit Çanga; Kazım Serhan Özcan

    2012-01-01

    The incidence of coronary artery anomalies has been reported between 0.6 to 1.3% in angiographic series and 0.3% in autopsy series. An isolated single coronary artery (SCA) is even a rarer congenital anomaly occurring in approximately 0.02% of the population. The ectopic origin of the right coronary artery (RCA) from the left anterior descending (LAD) artery is relatively rare and more benign than other types of anomalous origin of the RCAs. We report a case of an adult male patient with SCA ...

  5. An unusual renal accessory artery originating from the thoracic aorta and its potential clinical implications

    Directory of Open Access Journals (Sweden)

    Elvira Talović

    2013-05-01

    Full Text Available We report a case of an unsual anatomical vascular blood supply to the right kidney. In an analysis of kidneys, by dissection of 39 foetuses, additional renal arteries were found in 18 cases (46.15%. In only one case (2.5% was it noticed that the right kidney was supplied with blood by three renal arteries, one main and two additional arteries. One of the additional arteries, marked as the upper pole artery of aortic origin, separated from the thoracic aorta at the level of T11 (the eleventh thoracic rib, 1.5 cm above the truncus coeliacus. This artery, after passing through the diaphragm, entered the renal hilus at its upper part and served to vasculate that part of the kidney. Conclusion. The importance of this study is seen in the fact that anatomic knowledge of variations in the vascularization of the kidneys is of exceptional practical importance. Also, this information may concern transplant surgeons involved in living donor nephrectomies.

  6. Anomalous origin of the left coronary artery from the pulmonary artery in an elderly patient, football player in youth.

    Science.gov (United States)

    Facciorusso, Antonio; Lanna, Pompeo; Vigna, Carlo; Massaro, Raimondo; Stanislao, Mario; Santoro, Tiberio; Valle, Guido; Carbone, Carmine; Grilli, Gian Paolo; Fanelli, Raffaele

    2008-10-01

    Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital defect. Without surgical treatment, approximately 90% of infants die within the first year of life. Late presentation in the adult or elderly is rare. Factors that may lead to survival in advanced age include the development of intercoronary collaterals. Furthermore, the risk of sudden cardiac death due to ischaemic malignant ventricular dysrhythmias exists even in asymptomatic adult patients and, classically, is precipitated by exercise. We report the case of a 67-year-old man, a football player in his youth, always asymptomatic until presentation at our centre for symptomatic sustained ventricular tachycardia and shortness of breath on exertion. We show the features of the ECG, transthoracic echocardiography, angiography study of the coronary and the pulmonary system, myocardial basal and stress gated single photon emission computed tomography with Tc-tetrofosmin and cardiac CT 64 slices. The patient was referred to cardiac surgery. We believe that this patient's favourable course may be ascribed to the large network of collaterals from the right coronary artery supplying the entire heart. However, the exact reason why these favourable evolutions (both vascular and clinical) occur only in some individuals remains largely unknown.

  7. Sudden cardiac death as a presentation of anomalous origin of the left coronary artery from pulmonary artery in a young adult.

    Science.gov (United States)

    Pachon, Ronald; Bravo, Claudio; Niemiera, Mark

    2015-12-01

    Sudden cardiac death in 5-10% of cases is explained by patients with congenital abnormalities that include coronary artery malformations such as anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). We report a case of sudden cardiac death as the first presentation of ALCAPA in a young female with no history of hypertrophic cardiomyopathy. © The European Society of Cardiology 2014.

  8. The anomalous origin of the branch pulmonary artery from the ascending aorta.

    Science.gov (United States)

    Garg, Pankaj; Talwar, Sachin; Kothari, Shyam Sunder; Saxena, Anita; Juneja, Rajnish; Choudhary, Shiv Kumar; Airan, Balram

    2012-07-01

    The anomalous origin of one pulmonary artery branch from the aorta (AOPA) is rare. We report our single-institution surgical experience with this condition. Between January 1994 and February 2011, 17 patients (age: 1 month-25 years) with AOPA underwent surgery at our institute. Thirteen patients had an anomalous origin of the right pulmonary artery (RPA) while four had an anomalous origin of the left pulmonary artery (LPA) from the aorta. In patients with anomalous RPA, 11 patients had the proximal type and two patients had the distal type of AOPA. Four patients had associated Tetralogy of Fallot (TOF). In 14 patients, direct implantation into the main pulmonary artery was performed, while three patients required interpositon of a graft. There was one operative death due to persistent hypoxia in a 7-month old child with TOF and an anomalous LPA from the aorta. At a median follow-up of 36.5 months (range: 2-192 months), all 16 survivors were asymptomatic. On echocardiography, two patients showed a gradient of 25 and 30 mmHg across the anastomosis and are being followed up. In our experience, early repair of AOPA results in acceptable haemodynamic and anatomic results. Long-term survival can be expected with a low incidence of re-operation or re-intervention.

  9. Cambrian origin of the CYP27C1-mediated vitamin A1-to-A2 switch, a key mechanism of vertebrate sensory plasticity

    Science.gov (United States)

    Morshedian, Ala; Toomery, Matthew B.; Pollock, Gabriel E.; Frederiksen, Rikard; Enright, Jennifer; McCormick, Stephen; Cornwall, M. Carter; Fain, Gordon L.; Corbo, Joseph C.

    2017-01-01

    The spectral composition of ambient light varies across both space and time. Many species of jawed vertebrates adapt to this variation by tuning the sensitivity of their photoreceptors via the expression of CYP27C1, an enzyme that converts vitamin A1 into vitamin A2, thereby shifting the ratio of vitamin A1-based rhodopsin to red-shifted vitamin A2-based porphyropsin in the eye. Here, we show that the sea lamprey (Petromyzon marinus), a jawless vertebrate that diverged from jawed vertebrates during the Cambrian period (approx. 500 Ma), dynamically shifts its photoreceptor spectral sensitivity via vitamin A1-to-A2 chromophore exchange as it transitions between photically divergent aquatic habitats. We further show that this shift correlates with high-level expression of the lamprey orthologue of CYP27C1, specifically in the retinal pigment epithelium as in jawed vertebrates. Our results suggest that the CYP27C1-mediated vitamin A1-to-A2 switch is an evolutionarily ancient mechanism of sensory plasticity that appeared not long after the origin of vertebrates.

  10. Anomalous right coronary artery origin with interarterial pathway-importance of morphological origin assessment and the role of percutaneous interventionism.

    Science.gov (United States)

    García Iglesias, Daniel; Martínez Fernández, Lidia; Martín Fernández, María; García Suárez, Laura; García Pérez, Laura; Calvo Blanco, Juan; Cigarrán Sexto, Helena; Del Valle Fernández, Raquel; Morís de la Tassa, César

    2017-05-01

    Anomalies in coronary arteries (CA) are an important issue in cardiology and cardiovascular surgery. Specifically the anomalous origin of the right coronary artery (RCA) is of special importance because it is the most frequent anomaly. Clinical practice guidelines recommend the revascularization treatment in cases of interarterial pathway and documented myocardial ischemia and when hypoplasia, compression or obstruction is evident. We report two different cases of patients with anomalous origin of RCA and associated interarterial pathway. With them we want to highlight the different presentation forms of these patients and the different diagnostic alternatives available in each of the steps. In the patient with anomalous origin of the RCA and associated interarterial pathway, the first step after establishing the diagnosis is to rule out the presence of inducible ischemia. In those patients in whom ischemia induction tests are negative, the second step is to adequately assess the interarterial pathway, in order to rule out obstructions or compressions that also justify revascularization. In those cases in which all the tests are negative, the current evidence does not recommend revascularization, but adequate periodic follow-up is recommended. For this reason, we believe that the stress echocardiogram and exercise perfusion scintigraphy (based on availability and experience in each center) are fundamental because of their high sensitivity and specificity. We would also like to highlight the role that percutaneous interventionism can play in this type of clinical cases. Especially with patients of high surgical risk and in whom the percutaneous approach is feasible.

  11. Anomalous Origin of One Pulmonary Artery Branch From the Aorta: Role of MDCT Angiography.

    Science.gov (United States)

    Liu, Hui; Juan, Yu-Hsiang; Chen, Jimei; Xie, Zhaofeng; Wang, Qiushi; Zhang, Xiaoshen; Liang, Changhong; Huang, Hongfei; Kwong, Raymond Y; Saboo, Sachin S

    2015-05-01

    The purpose of this study was to evaluate the prevalence, MDCT angiography (MDCTA) appearance, associated congenital cardiovascular abnormalities, and prognosis of anomalous origin of one pulmonary artery from the aorta (AOPA) on the basis of MDCTA. We conducted a retrospective search of patients with AOPA from our database in a single center, consisting of 5729 patients referred for MDCTA with known or suspected congenital heart diseases from transthoracic echocardiography. The clinical information, subtypes of AOPA, associated cardiovascular anomalies, and surgical and clinical outcomes were retrospectively collected and analyzed. The MDCTA images were retrospectively processed for analysis, and the MDCTA and echocardiography images were interpreted by radiologist and cardiologist without knowledge of the actual diagnosis or surgical outcome. AOPA was seen in 19 patients (14 males and five females; median age, 3 months; range, 4 days-21 years) showing a prevalence of 0.33%. Anomalous origin of the right pulmonary artery (AORPA, 89%), proximal origin subtype of the AOPA (89%), and ipsilateral aortic wall origin of AOPA (58%) were more commonly seen. In addition to the benefit of preoperative planning, MDCTA also supplemented echocardiography by providing accurate diagnosis of AOPA and other associated cardiovascular anomalies compared with transthoracic echocardiography (TTE). We found a total of four patients (21%) with misdiagnosis by TTE, including three patients with underdiagnosis of AOPA and one patient with misdiagnosis as transposition of the great arteries. In addition, two other patients had AOPA diagnosed, but the associated patent ductus arteriosus (PDA) was not detected. MDCTA revealed 95% association with other congenital cardiovascular anomalies, including PDA (71% of AORPA), and aortic arch anomalies (100% of anomalous origin of the left pulmonary artery, AOLPA). The types of surgery depended on the MDCTA findings, including the sub-type, origin

  12. Anomalous origin of the right pulmonary artery from the abdominal aorta with aberrant right subclavian artery and left patent ductus arteriosus.

    Science.gov (United States)

    Fu, Songling; Xie, Chunhong; Gong, Fangqi; Zhu, Weihua

    2011-06-01

    Anomalous origin of the pulmonary artery (AOPA) from the aorta is a rare congenital heart malformation. This report describes a case of AOPA from the abdominal aorta in association with an aberrant right subclavian artery and a patent ductus arteriosus, which never has been reported previously in the literature.

  13. Redundant anomalous vertebral artery in a case of congenital irreducible atlantoaxial dislocation: Emphasizing on the differences from the first intersegemental artery and operative steps to prevent injury while performing C1-2 joint manipulation.

    Science.gov (United States)

    Patra, Devi P; Salunke, Pravin S; Sahoo, Sushanta K; Ghuman, Mandeep S

    2015-10-01

    Anomalous vertebral artery (VA), commonly the persistent first intersegmental artery (FIA) is often seen with congenital atlantoaxial dislocations (AAD). An unusual redundant/ectatic loop of VA passing below the C1 (upside down VA) has been described below and appears to be different from FIA. The operative technique to protect it while C1-2 joint manipulation has been described. A 35 year old male presented with progressive spastic quadriparesis after trivial trauma. Radiology showed irreducible atlantoaxial dislocation with occipitalised C1 and C2-3 fusion. The left VA was anomalous passing beneath the C1 arch with a redundant loop lying posterior to the C1-2 joint. This was unlike the persistent first intersegmental artery (FIA) and was safeguarded while dissecting the C1-2 facet. The artery was dissected and safeguarded while performing C1-2 joint manipulation. A redundant/ectatic loop lying posterior to C1-2 joint is an unusual variant of anomalous VA. Evaluation of preoperative radiology helps in diagnosing such anomalous VA. Dissection of the entire redundant loop of the anomalous artery is important in opening the C1-2 joint required for reduction and placement of spacer/ bone grafts to achieve good bony fusion. Also mobilizing the loop allows safe insertion of lateral mass screw. Care needs to be taken while fastening screws to prevent compression of the loop.

  14. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting as a complete heart block.

    Science.gov (United States)

    Math, Ravi S; Parakh, Neeraj; Sarin, Simarjot S; Tyagi, Sanjay

    2010-05-01

    A 51-year-old previously asymptomatic man presented with complete heart block (CHB). During pacemaker implantation, fluoroscopy showed a peculiar pattern of cardiac calcification. Coronary angiography, performed to determine the origin of calcification, demonstrated an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). A left ventriculogram showed normal ventricular contraction. Echocardiography demonstrated normal systolic function without any regional wall motion abnormality. The endocardium of the mid and basal portions of the anteroseptal, anterior and anterolateral walls as well as both of the papillary muscles were calcified. Specifically noted was a calcific bar extending across the base of the interventricular septum (IVS) on both the echocardiogram and the left ventricle angiogram. The development of CHB in the absence of transmural myocardial infarction is intriguing. It is likely that endocardial fibroelastosis during infancy led to endocardial fibrosis and scarring subsequent calcium deposition. Extension of this calcification into the conduction system may have led to CHB. This is the first report of an adult patient with ALCAPA presenting with CHB.

  15. Characteristic anatomical conformation of the vertebral artery causing vascular compression against the root exit zone of the facial nerve in patients with hemifacial spasm.

    Science.gov (United States)

    Park, Jung-Soo; Koh, Eun-Jeong; Choi, Ha-Young; Lee, Jong-Myong

    2015-03-01

    Hemifacial spasm (HFS) is caused by tortuous offending vessels near the facial nerve root exit zone. However, the definitive mechanism of offending vessel formation remains unclear. We hypothesized that vascular angulation and tortuosity, probably caused by uneven vertebral artery blood flow, result in vascular compression of the facial nerve root exit zone. The authors observed two anatomical characteristics of the vertebrobasilar arterial system in 120 subjects in the surgical group and 188 controls. The presence of the dominant vertebral artery (DVA) and laterality of the vertebrobasilar junction (VBJ) were observed. We also analyzed the morphological characteristics of the surgical group showing the presence of DVA. The morphological characteristics were classified into three types: type I had the VBJ and DVA on the same side, type II had the VBJ within 2 mm of the midline, and type III had the VBJ opposite the DVA. The DVA was more prevalent in the surgical group than in the control group (71 % versus 54 %, P DVA on the left (P DVA on the right (P DVA, which corresponds with the laterality of the HFS. In the surgical group with the DVA and HFS on the same side, type I was predominant, but in the surgical group with a contralateral DVA and HFS, type III was predominant. The presence of a DVA and shifting of the VBJ on the same side plays a role in the angulation and tortuosity of vessels in the perivertebrobasilar junction, resulting in neurovascular compression of the facial nerve root exit zone and thereby causing HFS.

  16. [Influence of needle-pricking bleeding combined with pulling-rotating manipulation on blood rheology in patients with vertebral artery type cervical spondylosis].

    Science.gov (United States)

    Chen, Dong; Zhong, Jian; Hong, Yan-Bo; Chen, Da-Dian; Deng, Lie-Hua; Cai, Ming-Xue; Zhang, Yue-Juan; Lin, Xiu-Hua; Zheng, Fu-Shi

    2009-10-01

    To observe the effect of needle-pricking bleeding combined with pulling-rotating manipulation and simple manipulation on blood rheology in vertebral artery type cervical spondylosis (VATCS) patients, so as to analyze their mechanisms in relieving VATCS. A total of 198 VATCS patients were randomly divided into treatment group (n=101) which was treated with needle-pricking plus pulling-rotating manipulation, and control group (n=97) which was treated with simple pulling-rotating manipulation, according to the random number table. The treatment was given once every 7 days, 9 times altogether. The peak systolic blood flow velocity (Vpeak), end-diastolic blood velocity (Vmin), pulsatility index (PI) and resistent index (RI) of bilateral vertebral arteries (VA) and basilar artery (BA) were detected by transcranial doppler sonography (TCD). Whole blood apparent viscosity and the plasma viscosity in the treatment group were determined by using a blood viscosimeter. Of the 101 and 97 VATCS cases in the treatment and control groups, 62 (61.38%) and 12 (12.37%) were cured basically, 23 (22.77%) and 26 (26.80%) experienced marked improvement, 14 (13.86%) and 41 (42.27%) were improved. 2 (1.98%) and 18 (18.55%) failed in the treatment, with the total effective rates being 98.01% and 81.44% separately. The effective rate of the treatment group was significantly higher than that of control group (Pmanipulation can significantly improve VATCS patients' clinical symptoms, which may be closely related to its effects in lowering vascular blood resistance and blood viscosity and increasing cerebral blood supply.

  17. Identification of Ohnolog Genes Originating from Whole Genome Duplication in Early Vertebrates, Based on Synteny Comparison across Multiple Genomes.

    Science.gov (United States)

    Singh, Param Priya; Arora, Jatin; Isambert, Hervé

    2015-07-01

    Whole genome duplications (WGD) have now been firmly established in all major eukaryotic kingdoms. In particular, all vertebrates descend from two rounds of WGDs, that occurred in their jawless ancestor some 500 MY ago. Paralogs retained from WGD, also coined 'ohnologs' after Susumu Ohno, have been shown to be typically associated with development, signaling and gene regulation. Ohnologs, which amount to about 20 to 35% of genes in the human genome, have also been shown to be prone to dominant deleterious mutations and frequently implicated in cancer and genetic diseases. Hence, identifying ohnologs is central to better understand the evolution of vertebrates and their susceptibility to genetic diseases. Early computational analyses to identify vertebrate ohnologs relied on content-based synteny comparisons between the human genome and a single invertebrate outgroup genome or within the human genome itself. These approaches are thus limited by lineage specific rearrangements in individual genomes. We report, in this study, the identification of vertebrate ohnologs based on the quantitative assessment and integration of synteny conservation between six amniote vertebrates and six invertebrate outgroups. Such a synteny comparison across multiple genomes is shown to enhance the statistical power of ohnolog identification in vertebrates compared to earlier approaches, by overcoming lineage specific genome rearrangements. Ohnolog gene families can be browsed and downloaded for three statistical confidence levels or recompiled for specific, user-defined, significance criteria at http://ohnologs.curie.fr/. In the light of the importance of WGD on the genetic makeup of vertebrates, our analysis provides a useful resource for researchers interested in gaining further insights on vertebrate evolution and genetic diseases.

  18. Identification of Ohnolog Genes Originating from Whole Genome Duplication in Early Vertebrates, Based on Synteny Comparison across Multiple Genomes.

    Directory of Open Access Journals (Sweden)

    Param Priya Singh

    2015-07-01

    Full Text Available Whole genome duplications (WGD have now been firmly established in all major eukaryotic kingdoms. In particular, all vertebrates descend from two rounds of WGDs, that occurred in their jawless ancestor some 500 MY ago. Paralogs retained from WGD, also coined 'ohnologs' after Susumu Ohno, have been shown to be typically associated with development, signaling and gene regulation. Ohnologs, which amount to about 20 to 35% of genes in the human genome, have also been shown to be prone to dominant deleterious mutations and frequently implicated in cancer and genetic diseases. Hence, identifying ohnologs is central to better understand the evolution of vertebrates and their susceptibility to genetic diseases. Early computational analyses to identify vertebrate ohnologs relied on content-based synteny comparisons between the human genome and a single invertebrate outgroup genome or within the human genome itself. These approaches are thus limited by lineage specific rearrangements in individual genomes. We report, in this study, the identification of vertebrate ohnologs based on the quantitative assessment and integration of synteny conservation between six amniote vertebrates and six invertebrate outgroups. Such a synteny comparison across multiple genomes is shown to enhance the statistical power of ohnolog identification in vertebrates compared to earlier approaches, by overcoming lineage specific genome rearrangements. Ohnolog gene families can be browsed and downloaded for three statistical confidence levels or recompiled for specific, user-defined, significance criteria at http://ohnologs.curie.fr/. In the light of the importance of WGD on the genetic makeup of vertebrates, our analysis provides a useful resource for researchers interested in gaining further insights on vertebrate evolution and genetic diseases.

  19. Technical strategy in a patient with symptomatic thoracic aneurysm near the origin of the left subclavian artery and left internal thoracic artery coronary graft.

    Science.gov (United States)

    Babic, Srdjan D; Radak, Djordje J; Sotirovic, Vuk A; Unic-Stojanovic, Dragana R; Babic, Dusan S; Popov, Petar Z; Sagic, Dragan Z

    2012-11-01

    Thoracic endovascular aortic repair (TEVAR) is a safe and reliable technique utilized in the treatment for aortic aneurysms. However, in up to 40% of patients, devices are typically placed over the left subclavian artery (LSA) origin. In this report, we present a case of a successful TEVAR procedure following the transposition of the LSA with protective carotico-axillary/carotid bypass in a patient with a patent left internal thoracic artery (LITA)-left anterior descending (LAD) coronary artery bypass graft and right internal carotid artery (ICA) occlusion. © 2012 Wiley Periodicals, Inc.

  20. Percutaneous coronary intervention in patients with anomalous origin of coronary artery presenting with acute coronary syndrome: A case series.

    Science.gov (United States)

    Karur, Satish; Patra, Soumya; Shankarappa, Ravindranath K; Agrawal, Navin; Math, Ravi S; Nanjappa, Manjunath C

    2013-09-01

    Coronary artery anomalies are found in 0.6%-1.5% of patients undergoing diagnostic coronary angiogram. Intervention in these patients poses a particular technical challenge secondary to the aberrancies in the vessel origin and course. From March 2011 to February 2013, 13 cases with complex coronary artery anomalies were observed among 2482 patients undergoing CAG (0.52%) at our cath lab. Only three patients had severe stenosis in the anomalous artery sufficient to require an intervention and had presented with myocardial infarction. PCI was performed successfully in these 3 patients two of which had anomalous left circumflex artery and the other having an anomalous right coronary artery.

  1. Surgical Treatment of Anomalous Origin of Right Coronary Artery in a Patient with Mitral Stenosis.

    Science.gov (United States)

    Refatllari, Ali; Likaj, Ermal; Dumani, Selman; Hasimi, Endri; Goda, Artan

    2016-03-15

    An anomalous origin of the right coronary artery is rarely observed, with a reported incidence between 0.026% and 0.25%. This condition is often completely asymptomatic and is found incidentally during angiographic evaluation for other cardiac diseases. However some patients present with exertion angina or sudden death. Surgical treatment in patients with anomalous RCA is still controversial. Treatment can be conservative, angioplasty or surgery. A 59-year-old man was admitted with severe mitral stenosis. He complained exertion and rest dyspnea, NYHA III class. He had sequels of embolic stroke, results of left atrial thrombus. Echocardiography showed calcified severe mitral stenosis with mitral orifice area of 1.1 square centimeters with PSPAP 60 mmHg and normal LV function. Routine coronary angiography before surgery showed aberrant origin of RCA from the left sinus of Valsalva with 90% stenosis at his origin. Multi-slice computed tomography proved the diagnosis of anomalous RCA arising from the left sinus of Valsalva and taking an inter-arterial course between the aorta and pulmonary artery. The patient underwent mitral valve replacement with mechanical St. Jude prosthesis No 29 and saphenous vein graft to RCA. We chose by-pass grafting techniques because after aortotomy, RCA was too close to LMCA, intramural course was too short and stenosis of RCA was outside of aortic wall. The patient's perioperative course was without complications and patient was discharged on the seventh postoperative day. Correction of anomalous of the origin of right coronary artery is mandatory in cases where patient has to be operated for other cardiac causes.

  2. Variations in the origin of the deep femoral artery: A meta-analysis.

    Science.gov (United States)

    Tomaszewski, Krzysztof A; Henry, Brandon Michael; Vikse, Jens; Pękala, Przemysław; Roy, Joyeeta; Svensen, Maren; Guay, Daniel; Hsieh, Wan Chin; Loukas, Marios; Walocha, Jerzy A

    2017-01-01

    The deep femoral artery (DFA) is the largest branch of the femoral artery (FA) and is responsible for vascularization of the thigh muscles. Knowledge of the anatomical variations in its origin point is important for surgeons and interventional radiologists. The aim of our study was to provide a comprehensive evidence-based assessment of its anatomical properties. An extensive search through the major electronic databases was conducted to find all articles reporting data on the anatomical characteristics of the DFA. No date limits or language restrictions were imposed. A total of 25 articles (n = 2,502 lower limbs) were included in the meta-analysis. Six different patterns of origin of the DFA from the FA were identified, the most common type being a posterior origin (38.8%, 95% CI 22.8-49.5%). The DFA most commonly branched off in the proximal third of the thigh, with a prevalence of 47.6% (95% CI 35.8-59.2%). The pooled mean distance of the DFA from its point of origin to the mid-inguinal point was 41.15 mm (95% CI 32.39-53.73). The point and level of origin of the DFA from the FA varies widely in the general population. Owing to this variability, accurate anatomical knowledge regarding the DFA is crucial for clinicians if iatrogenic injuries are to be avoided during procedures in the femoral region. Clin. Anat. 30:106-113, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Landmark discoveries in elucidating the origins of the hypothalamic-pituitary system from the perspective of a basal vertebrate, sea lamprey.

    Science.gov (United States)

    Sower, Stacia A

    2017-10-27

    as essential regulatory systems in all vertebrates. This paper will provide a brief snapshot of my discoveries, collaborations and latest findings including phylogenomic analyses on the origins, co-evolution and divergence of ligand and receptor protein families from the perspective of the lamprey hypothalamic-pituitary system. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. [Effects of a combined regime of auricular-plaster and body acupuncture in treatment of cervical spondylosis of vertebral artery type].

    Science.gov (United States)

    Zhang, Hui-Lan; Zhong, Yuan-Ming; Peng, Guo-Min; Wan, Yi-Gang

    2006-10-01

    To study effects of a combined regime of auricular-plaster and body acupuncture in treatment of cervical spondylosis of vertebral artery type and make a preliminary revelation of the mechanism. Ninety-two patients were randomly divided into 2 groups, the treatment group (n = 56) received the combined regime of auricular-plaster and body acupuncture, and the control group (n = 36) received treatment with body acupuncture. Clinical symptoms and signs, therapeutic effect and some indexes about vertebrobasilar hema-kinetics and hema-rheology were investigated before and after treatment. The treatment group was better than the control group in the clinical overall effective rate (89.29%) and the clinically control rate (17. 85%), and in improving the following indexes, including dizziness and headache, the vertebrobasilar volume and rate of blood flow etab and IR (P Malaysia and in China.

  5. Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Beauchamp Kathryn M

    2011-07-01

    Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

  6. Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Bonati, Leo H

    2009-10-01

    In the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), early recurrent carotid stenosis was more common in patients assigned to endovascular treatment than it was in patients assigned to endarterectomy (CEA), raising concerns about the long-term effectiveness of endovascular treatment. We aimed to investigate the long-term risks of restenosis in patients included in CAVATAS.

  7. Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery in a Patient with Ascending Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Ufuk Gürkan

    2012-04-01

    Full Text Available The incidence of coronary artery anomalies has been reported between 0.6 to 1.3% in angiographic series and 0.3% in autopsy series. An isolated single coronary artery (SCA is even a rarer congenital anomaly occurring in approximately 0.02% of the population. The ectopic origin of the right coronary artery (RCA from the left anterior descending (LAD artery is relatively rare and more benign than other types of anomalous origin of the RCAs. We report a case of an adult male patient with SCA anomaly in which the RCA takes off from the mid LAD. To the best of our knowledge, SCA anomaly coinciding with ascending aortic aneurysm which was treated with Bentall operation has never been described before.

  8. An unusual, duplicate origin of the anterior choroidal artery with aneurysm: a case report.

    Science.gov (United States)

    Chenin, Louis; Chivot, Cyril; Toussaint, Patrick; Deramond, Hervé; Peltier, Johann

    2015-12-01

    Aneurysms of the anterior choroidal artery (AChoA) are rare and often difficult to treat. Variations may be present and must be identified prior to treatment. We report a unique case of a ruptured aneurysm located at the origin of a duplicate branch of the AChoA. A 56-year-old male was admitted to our university hospital for coma. A brain CT scan showed a subarachnoid hemorrhage, and CT angiography revealed a duplication of the right AChoA, with an aneurysm located at the branch's origin. We decided to embolize this aneurysm. Four weeks later, our patient was able to transfer to the rehabilitation unit. To the best of our knowledge, this is one of the first descriptions of an aneurysm located at the origin of a duplicate branch of the AChoA.

  9. Characterization of the neurohypophysial hormone gene loci in elephant shark and the Japanese lamprey: origin of the vertebrate neurohypophysial hormone genes

    Directory of Open Access Journals (Sweden)

    Brenner Sydney

    2009-02-01

    Full Text Available Abstract Background Vasopressin and oxytocin are mammalian neurohypophysial hormones with distinct functions. Vasopressin is involved mainly in osmoregulation and oxytocin is involved primarily in parturition and lactation. Jawed vertebrates contain at least one homolog each of vasopressin and oxytocin, whereas only a vasopressin-family hormone, vasotocin, has been identified in jawless vertebrates. The genes encoding vasopressin and oxytocin are closely linked tail-to-tail in eutherian mammals whereas their homologs in chicken, Xenopus and coelacanth (vasotocin and mesotocin are linked tail-to-head. In contrast, their pufferfish homologs, vasotocin and isotocin, are located on the same strand of DNA with isotocin located upstream of vasotocin and separated by five genes. These differences in the arrangement of the two genes in different bony vertebrate lineages raise questions about their origin and ancestral arrangement. To trace the origin of these genes, we have sequenced BAC clones from the neurohypophysial gene loci in a cartilaginous fish, the elephant shark (Callorhinchus milii, and in a jawless vertebrate, the Japanese lamprey (Lethenteron japonicum. We have also analyzed the neurohypophysial hormone gene locus in an invertebrate chordate, the amphioxus (Branchiostoma floridae. Results The elephant shark neurohypophysial hormone genes encode vasotocin and oxytocin, and are linked tail-to-head like their homologs in coelacanth and non-eutherian tetrapods. Besides the hypothalamus, the two genes are also expressed in the ovary. In addition, the vasotocin gene is expressed in the kidney, rectal gland and intestine. These expression profiles indicate a paracrine role for the two hormones. The lamprey locus contains a single neurohypophysial hormone gene, the vasotocin. The synteny of genes in the lamprey locus is conserved in elephant shark, coelacanth and tetrapods but disrupted in teleost fishes. The amphioxus locus encodes a single

  10. Congenital Spondylolytic Spondylolisthesis of C2 Vertebra Associated With Atlanto-Axial Dislocation, Chiari Type I Malformation, and Anomalous Vertebral Artery: Case Report With Review Literature.

    Science.gov (United States)

    Sardhara, Jayesh; Pavaman, Sindgikar; Das, Kuntal; Srivastava, Arun; Mehrotra, Anant; Behari, Sanjay

    2016-11-01

    Congenital spondylolytic spondylolisthesis of C2 vertebra resulting from deficient posterior element of the axis is rarely described in the literature. We describe a unique case of agenesis of posterior elements of C2 with craniovertebral junction anomalies consisting of osseous, vascular, and soft tissue anomalies. A 26-year-old man presented with symptoms of upper cervical myelopathy of 12 months' duration. A computed tomography scan of the cervical spine including the craniovertebral junction revealed spondylolisthesis of C2 over C3, atlantoaxial dislocation, occipitalization of the atlas, hypoplasia of the odontoid, and cleft posterior C1 arch. Additionally, the axis vertebra was found devoid of its posterior elements except bilaterally rudimentary pedicles. Magnetic resonance imaging revealed tonsilar herniation, suggesting associated Chiari type I malformation. CT angiogram of the vertebral arteries displayed persistent bilateral first intersegmental arteries crossing the posterior aspect of the C1/2 facet joint. This patient underwent foramen magnum decompression, C3 laminectomy with occipito-C3/C4 posterior fusion using screw and rod to maintain the cervical alignment and stability. We report this rare constellation of congenital craniovertebral junction anomaly and review the relevant literature. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, Thomas; Kofoed, Klaus Fuglsang; Helqvist, Steffen

    2008-01-01

    the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion....... Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery....

  12. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) presenting with ventricular fibrillation in an adult: a case report

    DEFF Research Database (Denmark)

    Kristensen, T.; Kofoed, Klaus Fuglsang; Helqvist, S.

    2008-01-01

    the right coronary artery is sufficient and symptoms may be subtle or even absent. Arrhythmias or sudden cardiac death in adult life may be the first clinical presentation in patients with ALCAPA. We report a case, where a 39-year old woman presented with ventricular fibrillation during phycial exertion....... Coronary angiography and CT-angiography revealed an anomalous origin of the left coronary artery, and an aortic reimplantation of the left coronary artery was performed followed by ICD implantation. A review of the literature on ALCAPA is presented along with CT images before and after surgery...

  13. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial.

    Science.gov (United States)

    Halkes, P H A; van Gijn, J; Kappelle, L J; Koudstaal, P J; Algra, A

    2006-05-20

    Results of trials of aspirin and dipyridamole combined versus aspirin alone for the secondary prevention of vascular events after ischaemic stroke of presumed arterial origin are inconsistent. Our aim was to resolve this uncertainty. We did a randomised controlled trial in which we assigned patients to aspirin (30-325 mg daily) with (n=1363) or without (n=1376) dipyridamole (200 mg twice daily) within 6 months of a transient ischaemic attack or minor stroke of presumed arterial origin. Our primary outcome event was the composite of death from all vascular causes, non-fatal stroke, non-fatal myocardial infarction, or major bleeding complication, whichever happened first. Treatment was open, but auditing of outcome events was blinded. Primary analysis was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial (number ISRCTN73824458) and with (NCT00161070). Mean follow-up was 3.5 years (SD 2.0). Median aspirin dose was 75 mg in both treatment groups (range 30-325); extended-release dipyridamole was used by 83% (n=1131) of patients on the combination regimen. Primary outcome events arose in 173 (13%) patients on aspirin and dipyridamole and in 216 (16%) on aspirin alone (hazard ratio 0.80, 95% CI 0.66-0.98; absolute risk reduction 1.0% per year, 95% CI 0.1-1.8). Addition of the ESPRIT data to the meta-analysis of previous trials resulted in an overall risk ratio for the composite of vascular death, stroke, or myocardial infarction of 0.82 (95% CI 0.74-0.91). Patients on aspirin and dipyridamole discontinued trial medication more often than those on aspirin alone (470 vs 184), mainly because of headache. The ESPRIT results, combined with the results of previous trials, provide sufficient evidence to prefer the combination regimen of aspirin plus dipyridamole over aspirin alone as antithrombotic therapy after cerebral ischaemia of arterial origin.

  14. Vertebral artery variations and osseous anomaly at the C1-2 level diagnosed by 3D CT angiography in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Wakao, Norimitsu; Kamiya, Mitsuhiro [Aichi Medical University, Department of Spine Center, Aichi (Japan); Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan); Takeuchi, Mikinobu; Hirasawa, Atsuhiko; Kawanami, Katsuhisa; Takayasu, Masakazu [Aichi Medical University, Department of Spine Center, Aichi (Japan); Nishimura, Manabu [Aichi Medical University, Department of Radiology, Nagakute, Aichi (Japan); Riew, K.D. [Washington University, Department of Orthopedic Surgery, St. Louis, MO (United States); Imagama, Shiro [Nagoya University, Department of Orthopedic Surgery, Nagoya, Aichi (Japan); Sato, Keiji [Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan)

    2014-10-15

    The craniovertebral junction is anatomically complicated. Representative vertebral artery (VA) variations include the persistent first intersegmental artery (FIA), fenestration of the VA above and below C1 (FEN), posterior inferior cerebellar artery (PICA) from C1/2, and high-riding VA (HRVA). The ponticulus posticus (PP) is a well-known osseous anomaly at C1. Although those anomalies are frequent in patients with cervical deformity, the prevalence of these in subjects with normal cervical spines is still unknown. The aim of this study is to investigate the variations and prevalence of vascular and osseous anomalies based on three-dimensional computed tomographic (3D CT) angiography in patients without any cervical diseases, such as rheumatoid arthritis, Klippel-Feil syndrome, or Down syndrome. Eligible subjects were patients who underwent 3D CT angiography by the Department of Otorhinolaryngology and Internal Medicine from January 2009 to October 2013 in our institution. The authors defined a HRVA as a C2 pedicle with a maximum diameter of 4 mm or less. Among 480 subjects with a mean age of 63.1 years, 387 patients were eligible. One hundred and eighteen subjects were female, and 269 were male. HRVA was observed in 10.1 % of patients (39 out of 387 cases), FIA in 1.8 % (7 cases), FEN in 1.3 % (5 cases), and PICA in 1.3 % (5 cases). PP was observed in 6.2 % of patients (24 cases). According to past reports, many VA anomalies could be attributed to congenital or acquired conditions (e.g., rheumatoid arthritis). However, VA anomalies appear to exist even in patients without any such cervical diseases. (orig.)

  15. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Aslaner, Ramazan; Pekcevik, Yeliz; Sahin, Hilal [Dept. of Radiology, Tepecik Training and Research Hospital, Izmir (Turkmenistan); Toka, Onur [Dept. of Statistics, Hacettepe University, Ankara (Turkmenistan)

    2017-04-15

    Knowing the origin of the inferior phrenic artery (IPA) is important prior to surgical interventions and interventional radiological procedures related to IPA. We aimed to identify variations in the origin of IPA and to investigate the relationship between the origin of IPA and celiac axis variations using computed tomography angiography (CTA). The CTA images of 1000 patients (737 male and 263 female, the mean age 60, range 18–94 years) were reviewed in an analysis of IPA and celiac axis variations. The origin of IPA was divided into two groups, those originating as a common trunk and those originating independently without a truncus. The relationship between the origin of IPA and celiac axis variation was analyzed using Pearson's chi-square test. Both IPAs originated from a common trunk in 295 (29.5%) patients. From which the majority of the common trunk originated from the aorta. Contrastingly, the inferior phrenic arteries originated from different origins in 705 (70.5%) patients. The majority of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) originated independently from the celiac axis. Variation in the celiac axis were detected in 110 (11%) patients. The origin of IPA was found to be significantly different in the presence of celiac axis variation. The majority of IPA originated from the aorta in patients with a common IPA trunk, while the majority of RIPA and LIPA originating from the celiac axis in patients without a common IPA trunk. Thus, the origin of IPA may widely differ in the presence of celiac axis variation.

  16. Variations in the Origin of Inferior Phrenic Arteries and Their Relationship to Celiac Axis Variations on CT Angiography.

    Science.gov (United States)

    Aslaner, Ramazan; Pekcevik, Yeliz; Sahin, Hilal; Toka, Onur

    2017-01-01

    Knowing the origin of the inferior phrenic artery (IPA) is important prior to surgical interventions and interventional radiological procedures related to IPA. We aimed to identify variations in the origin of IPA and to investigate the relationship between the origin of IPA and celiac axis variations using computed tomography angiography (CTA). The CTA images of 1000 patients (737 male and 263 female, the mean age 60, range 18-94 years) were reviewed in an analysis of IPA and celiac axis variations. The origin of IPA was divided into two groups, those originating as a common trunk and those originating independently without a truncus. The relationship between the origin of IPA and celiac axis variation was analyzed using Pearson's chi-square test. Both IPAs originated from a common trunk in 295 (29.5%) patients. From which the majority of the common trunk originated from the aorta. Contrastingly, the inferior phrenic arteries originated from different origins in 705 (70.5%) patients. The majority of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) originated independently from the celiac axis. Variation in the celiac axis were detected in 110 (11%) patients. The origin of IPA was found to be significantly different in the presence of celiac axis variation. The majority of IPA originated from the aorta in patients with a common IPA trunk, while the majority of RIPA and LIPA originating from the celiac axis in patients without a common IPA trunk. Thus, the origin of IPA may widely differ in the presence of celiac axis variation.

  17. An unusual origin of the celiac trunk and the superior mesenteric artery in the thorax.

    Science.gov (United States)

    Matusz, Petru; Iacob, Nicoleta; Miclaus, Gratian D; Pureca, Ana; Ples, Horia; Loukas, Marios; Tubbs, R Shane

    2013-11-01

    The authors report a case of a 44-year-old male found to have unusual origins of the celiac trunk (CT) and superior mesernteric artrery (SMA) as revealed by routine multidetector computed tomograph (MDCT) angiography. The CT and SMA originate from the thoracic aorta (TA) 21 mm and 9 mm above the aortic hiatus, respectively. The median arcuate ligament (MAL) is located at the level of the L1-L2 intervertebral disc. The course of the CT descends in the thoracic cavity making a 14° acute downward angle in front of the TA; below the level of the MAL, the CT descends, making an angle of 47°. The course of the SMA descends at both the thoracic and abdominal level making an angle of 17°, and having an aortomesenteric distance of 9 mm at the level of the third part of the duodenum. In the present case, the supradiaphragmatic origin of the CT and the SMA was determined by their incomplete caudal descent, associated with a pronounced apparent descent of the diaphragm. A thoracic origin of the CT and SMA and the acute downward aortomesenteric angle (17°) associated with a reduced aortomesenteric distance at the level of the third part of the duodenum (9 mm), although no clinical signs are present, may predispose the patient to develop simultaneously a triple syndrome: the compression of CT by MAL (celiac axis compression syndrome), the compression of SMA by MAL (superior mesenteric artery compression syndrome), and the compression of the duodenum by the SMA (superior mesenteric artery syndrome). Copyright © 2013 Wiley Periodicals, Inc.

  18. [Echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta].

    Science.gov (United States)

    Reyes de la Cruz, Lorenzo; Vizcaíno Alarcón, Alfredo; Arévalo Salas, Alexis; Espinosa Islas, Gonzalo; Bolio Cerdán, Alejandro; Arteaga Martínez, Manuel

    2003-01-01

    To present our experience in the echocardiographic diagnosis of anomalous origin of one pulmonary artery from the ascending aorta (AOPA). To analyze its clinical presentation, treatment and outcomes with special emphasis in the echocardiographic data. We reviewed restrospectively the clinical, hemodynamic data, and surgical findings of patients with an echocardiographic diagnosis of AOPA studied in the Hospital Infantil of Mexico "Federico Gomez" from 1991 to 2002. The study includes 12 children with AOPA; Seven were males. The average age at diagnosis was two months; 4 in neonatal period, 3 under 1 year and 5 older than 1 year. The diagnosis was established prospectively by echocardiography in all patients and it was confirmed by angiography in 8 and at surgery in 9. Ten had anomalous origin of right pulmonary artery. The associated anomalies were patent ductus arteriosus in 6, ventricular septal defect in 2 and aortopulmonary window, atrioventricular discordance, double outlet right ventricle and tetralogy of Fallot in one case each. Nine underwent corrective surgery of all the anomalies. One patient died on the sixth postoperative day; the remaining are in good condition without stenosis at the site of the anastomosis. Surgery was refused in one. One patient was not candidate to surgery due to advanced obstructive pulmonary vascular disease (OPVD) and one case is awaiting surgery. The diagnosis of AOPA may be established with precision through echocardiography. Cardiac catheterization is seldom needed to confirm morphology but is mandatory in older children with suspected of OPVD.

  19. Functional Desaturase Fads1 (Δ5) and Fads2 (Δ6) Orthologues Evolved before the Origin of Jawed Vertebrates

    Science.gov (United States)

    Castro, Luís Filipe Costa; Monroig, Óscar; Leaver, Michael J.; Wilson, Jonathan; Cunha, Isabel; Tocher, Douglas R.

    2012-01-01

    Long-chain polyunsaturated fatty acids (LC-PUFAs) such as arachidonic (ARA), eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids are essential components of biomembranes, particularly in neural tissues. Endogenous synthesis of ARA, EPA and DHA occurs from precursor dietary essential fatty acids such as linoleic and α-linolenic acid through elongation and Δ5 and Δ6 desaturations. With respect to desaturation activities some noteworthy differences have been noted in vertebrate classes. In mammals, the Δ5 activity is allocated to the Fads1 gene, while Fads2 is a Δ6 desaturase. In contrast, teleosts show distinct combinations of desaturase activities (e.g. bifunctional or separate Δ5 and Δ6 desaturases) apparently allocated to Fads2-type genes. To determine the timing of Fads1-Δ5 and Fads2-Δ6 evolution in vertebrates we used a combination of comparative and functional genomics with the analysis of key phylogenetic species. Our data show that Fads1 and Fads2 genes with Δ5 and Δ6 activities respectively, evolved before gnathostome radiation, since the catshark Scyliorhinus canicula has functional orthologues of both gene families. Consequently, the loss of Fads1 in teleosts is a secondary episode, while the existence of Δ5 activities in the same group most likely occurred through independent mutations into Fads2 type genes. Unexpectedly, we also establish that events of Fads1 gene expansion have taken place in birds and reptiles. Finally, a fourth Fads gene (Fads4) was found with an exclusive occurrence in mammalian genomes. Our findings enlighten the history of a crucially important gene family in vertebrate fatty acid metabolism and physiology and provide an explanation of how observed lineage-specific gene duplications, losses and diversifications might be linked to habitat-specific food web structures in different environments and over geological timescales. PMID:22384110

  20. Functional desaturase Fads1 (Δ5 and Fads2 (Δ6 orthologues evolved before the origin of jawed vertebrates.

    Directory of Open Access Journals (Sweden)

    Luís Filipe Costa Castro

    Full Text Available Long-chain polyunsaturated fatty acids (LC-PUFAs such as arachidonic (ARA, eicosapentaenoic (EPA and docosahexaenoic (DHA acids are essential components of biomembranes, particularly in neural tissues. Endogenous synthesis of ARA, EPA and DHA occurs from precursor dietary essential fatty acids such as linoleic and α-linolenic acid through elongation and Δ5 and Δ6 desaturations. With respect to desaturation activities some noteworthy differences have been noted in vertebrate classes. In mammals, the Δ5 activity is allocated to the Fads1 gene, while Fads2 is a Δ6 desaturase. In contrast, teleosts show distinct combinations of desaturase activities (e.g. bifunctional or separate Δ5 and Δ6 desaturases apparently allocated to Fads2-type genes. To determine the timing of Fads1-Δ5 and Fads2-Δ6 evolution in vertebrates we used a combination of comparative and functional genomics with the analysis of key phylogenetic species. Our data show that Fads1 and Fads2 genes with Δ5 and Δ6 activities respectively, evolved before gnathostome radiation, since the catshark Scyliorhinus canicula has functional orthologues of both gene families. Consequently, the loss of Fads1 in teleosts is a secondary episode, while the existence of Δ5 activities in the same group most likely occurred through independent mutations into Fads2 type genes. Unexpectedly, we also establish that events of Fads1 gene expansion have taken place in birds and reptiles. Finally, a fourth Fads gene (Fads4 was found with an exclusive occurrence in mammalian genomes. Our findings enlighten the history of a crucially important gene family in vertebrate fatty acid metabolism and physiology and provide an explanation of how observed lineage-specific gene duplications, losses and diversifications might be linked to habitat-specific food web structures in different environments and over geological timescales.

  1. The sea lamprey Petromyzon marinus genome reveals the early origin of several chemosensory receptor families in the vertebrate lineage

    Directory of Open Access Journals (Sweden)

    Zhang Ziping

    2009-07-01

    Full Text Available Abstract Background In gnathostomes, chemosensory receptors (CR expressed in olfactory epithelia are encoded by evolutionarily dynamic gene families encoding odorant receptors (OR, trace amine-associated receptors (TAAR, V1Rs and V2Rs. A limited number of OR-like sequences have been found in invertebrate chordate genomes. Whether these gene families arose in basal or advanced vertebrates has not been resolved because these families have not been examined systematically in agnathan genomes. Results Petromyzon is the only extant jawless vertebrate whose genome has been sequenced. Known to be exquisitely sensitive to several classes of odorants, lampreys detect fewer amino acids and steroids than teleosts. This reduced number of detectable odorants is indicative of reduced numbers of CR gene families or a reduced number of genes within CR families, or both, in the sea lamprey. In the lamprey genome we identified a repertoire of 59 intact single-exon CR genes, including 27 OR, 28 TAAR, and four V1R-like genes. These three CR families were expressed in the olfactory organ of both parasitic and adult life stages. Conclusion An extensive search in the lamprey genome failed to identify potential orthologs or pseudogenes of the multi-exon V2R family that is greatly expanded in teleost genomes, but did find intact calcium-sensing receptors (CASR and intact metabotropic glutamate receptors (MGR. We conclude that OR and V1R arose in chordates after the cephalochordate-urochordate split, but before the diversification of jawed and jawless vertebrates. The advent and diversification of V2R genes from glutamate receptor-family G protein-coupled receptors, most likely the CASR, occurred after the agnathan-gnathostome divergence.

  2. Operative nuances to safeguard anomalous vertebral artery without compromising the surgery for congenital atlantoaxial dislocation: untying a tough knot between vessel and bone.

    Science.gov (United States)

    Salunke, Pravin; Futane, Sameer; Sahoo, Sushant K; Ghuman, Mandeep S; Khandelwal, Niranjan

    2014-01-01

    Stabilization of the craniovertebral junction (CVJ) by using lateral masses requires extensive dissection. The vertebral artery (VA) is commonly anomalous in patients with congenital CVJ anomaly. Such a vessel is likely to be injured during dissection or screw placement. In this study the authors discuss the importance of preoperative evaluation and certain intraoperative steps that reduce the chances of injury to such vessels. A 3D CT angiogram was obtained in 15 consecutive patients undergoing surgery for congenital atlantoaxial dislocation. The course of the VA and its relationship to the C1-2 facets was studied in these patients. The anomalous VA was exposed intraoperatively, facet surfaces were drilled in all, and the screws were placed according to the disposition of the vessel. A skeletal anomaly was found in all 10 patients who had an anomalous VA. Four types of variations were noted: 1) the first intersegmental artery in 5 patients (bilateral in 1); 2) fenestration of VA in 1 patient; 3) anomalous posterior inferior cerebellar artery crossing the C1-2 joint in 1 patient; and 4) medial loop of VA in 5 patients. The anomalous vessel was dissected and the facet surfaces were drilled in all. The C-1 lateral mass screw was placed under vision, taking care not to compromise the anomalous vessel, although occipital screws or sublaminar wires were used in the initial cases. A medial loop of the VA necessitated placement of transpedicular or C-2 lateral mass screws instead of pars interarticularis screws. The anomalous vessel was injured in none. Preoperative 3D CT angiography is a highly useful method of imaging the artery in patients with CVJ anomaly. It helps in identifying the anomalous VA or its branch and its relationship to the C1-2 facets. The normal side should be surgically treated and distracted first because this helps in opening the abnormal side, aiding in dissection. In the posterior approach the C-2 nerve root is always encountered before the

  3. Multi-Contrast High-Resolution Magnetic Resonance Findings of Spontaneous and Unruptured Intracranial Vertebral Artery Dissection: Qualitative and Quantitative Analysis According to Stages.

    Science.gov (United States)

    Park, Kye Jin; Jung, Seung Chai; Kim, Ho Sung; Choi, Choong-Gon; Kim, Sang Joon; Lee, Deok Hee; Suh, Dae Chul; Kwon, Sun U; Kang, Dong-Wha; Kim, Jong S

    2016-01-01

    Although high-resolution magnetic resonance imaging (HR-MRI) has been used as a strong imaging method for diagnosing intracranial vertebral artery dissection (IVAD), the diagnosis is sometimes challenging because a dissection has geometric changes in the natural course. The radiologic features may change or disappear over time, which makes the diagnosis confusing. Our study was to present radiological findings according to the stages in spontaneous and unruptured, IVAD on 3T HR-MRI and to guide the age estimation of IVAD with the distinguishing findings according to the stages. From January 2011 to July 2014, the 41 vertebral arteries (M:F = 18:12; age range 32-67 years) were retrospectively enrolled. Spontaneous, unruptured IVAD was diagnosed if it had a clear onset based on clinical and radiological findings. The stages were classified as acute (0-3 days), early subacute (3-10 days), late subacute (10-60 days) and chronic stage (>60 days; recovery and non-recovery groups) according to the time intervals from symptom onset, based on the prior published studies. HR-MR findings were assessed and compared in the intimal flap, double lumen, aneurysmal dilatation (maximal outer diameter, maximal wall thickness, wall thickness index and remodeling index), intramural hematoma (relative signal intensity) and vessel wall enhancement according to the stages with qualitative and quantitative methods. Two radiologists analyzed the HR-MR findings with consensus reading. IVAD was classified into acute (n = 6), early subacute (n = 8), late subacute (n = 16) and chronic (n = 11) stages. HR-MR dissection findings such as intimal flap, double lumen, aneurysmal dilatation and intramural hematoma significantly decreased from the earlier stages to the chronic stage (p stages followed by a significant decrease in the chronic stage recovery group (p stage and decreased in the chronic stage (p stages and the chronic stage in spontaneous and unruptured IVAD. Characterization of these

  4. Anatomical study of occipital triangles: the 'inferior' suboccipital triangle, a useful vertebral artery landmark for safe postero-lateral skull base surgery.

    Science.gov (United States)

    La Rocca, Giuseppe; Altieri, Roberto; Ricciardi, Luca; Olivi, Alessandro; Della Pepa, Giuseppe Maria

    2017-10-01

    Vertebral artery (VA) identification within the suboccipital triangle is a key step in craniocervical junction surgery. Often VA exposition at this level is arduous (space-occupying lesions, previous surgery); to identify VA more proximally may prove useful in complex cases. An alternative triangle is present just below the suboccipital one, where VA can be easily controlled; we named it the inferior suboccipital triangle (IST). The aim of the study is to identify IST anatomical relations and VA space orientation and evaluate its practical utility in surgery. An anatomical study was performed on ten sides of five injected cadaverdic specimens. Relevant anatomical data were databased. The IST is limited superiorly by the inferior oblique muscle, inferolaterally by the posterior intertransversarii muscle and inferomedially by the C2 lamina; VA at this level has a vertical course with a slight medial to lateral direction (mean 10.8°) and minor posterior to anterior inclination (mean 3.4°). VA within the IST has a constant course without significant loops or kinkings; periarterial venous plexus is less represented at this level. The IST measures an average of 1.89 cm2, and VA at this level has an average length of 98 mm. IST is a significantly large anatomical space where the VA course is rather regular, and its length is sufficient for vascular proximal control purposes. Periarterial venous plexus is less evident at this level, easing the surgical exposure. VA exposition within the IST can be used as an alternative option when space-occupying lesions, scars and stabilisation devices make arterial dissection hazardous in more cranial V3 segments.

  5. Open aortic arch surgery in chronic dissection with visceral arteries originating from different lumens.

    Science.gov (United States)

    Urbanski, Paul P; Bougioukakis, Petros; Deja, Marek A; Diegeler, Anno; Irimie, Vadim; Lenos, Aristidis; Zembala, Michal O

    2016-05-01

    Surgical management of chronic aortic dissection is controversial, especially when the dissection extends into the abdominal aorta in which the visceral arteries originate from different lumens and is combined with aortic arch pathology necessitating surgery. The aim of the study was to evaluate the results of open surgery in this complex aortic pathology. Between June 2002 and 2015, a total of 17 patients (median age 57, range 32-76 years) necessitating complete arch replacement presented complex chronic dissection of the thoraco-abdominal aorta with the visceral arteries originating from different lumens. Fourteen patients (82%) had had previous cardiac surgery, which was performed on the proximal aorta in all but one because of acute type A dissection. Nine patients without considerable dilatation of the descending aorta received aortic arch replacement with distal resection of the dissection membrane, and 8 patients with progressive dilatation of the thoracic aorta underwent aortic arch and descending aorta replacement via clamshell approach. No early (defined as 30-day, 90-day and in-hospital period) deaths, strokes or spinal cord injuries occurred. Only 1 patient (6%) presented temporary neurological dysfunctions (delirium, agitation), which resolved completely before discharge, and an injury of the recurrent laryngeal nerve was documented in 2 patients (12%). Temporary dialysis was necessary in 1 case. The follow-up was complete for all patients. All but one patient, who died due to leukaemia 23 months after surgery, were alive at the last follow-up (median duration 33 months, range 2-118 months). No patient needed a reoperation or an intervention on the thoracic and/or abdominal aorta. Moreover, no noticeable progression of the chronic dissection in the downstream aorta was documented in any patient. The results after conventional aortic arch repair with distal resection of the dissection membrane and, if necessary, with replacement of the progressively

  6. What is the origin of the labyrinthine artery among black Kenyans ...

    African Journals Online (AJOL)

    Three hundred and fourty six arteries from one hundred and seventy-three formalin fixed brains were examined by dissection at the Department of Human Anatomy University of Nairobi, Kenya. Labyrinthine artery arose from basilar artery in 260 (75.1%); as common trunk with anterior inferior cerebellar artery in 48 (13.9%) ...

  7. The origin of mean arterial and jugular venous blood pressures in giraffes.

    Science.gov (United States)

    Mitchell, Graham; Maloney, Shane K; Mitchell, Duncan; Keegan, D James

    2006-07-01

    Using a mechanical model of the giraffe neck and head circulation consisting of a rigid, ascending, 'carotid' limb, a 'cranial' circulation that could be rigid or collapsible, and a descending, 'jugular' limb that also could be rigid or collapsible, we have analyzed the origin of the high arterial and venous pressures in giraffe, and whether blood flow is assisted by a siphon. When the tubes were rigid and the 'jugular' limb exit was lower than the 'carotid' limb entrance a siphon operated, 'carotid' hydrostatic pressures became more negative, and flow was 3.3 l min(-1) but ceased when the 'cranial' and 'jugular' limbs were collapsible or when the 'jugular' limb was opened to the atmosphere. Pumping water through the model produced positive pressures in the 'carotid' limb similar to those found in giraffe. Applying an external 'tissue' pressure to the 'jugular' tube during pump flow produced the typical pressures found in the jugular vein in giraffe. Constriction of the lowest, 'jugular cuff', portion of the 'jugular' limb showed that the cuff may augment the orthostatic reflex during head raising. Except when all tubes were rigid, pressures were unaffected by a siphon. We conclude that mean arterial blood pressure in giraffes is a consequence of the hydrostatic pressure generated by the column of blood in the neck, that tissue pressure around the collapsible jugular vein produces the known jugular pressures, and that a siphon does not assist flow through the cranial circulation.

  8. Sirolimus-eluting stents for the treatment of symptomatic extracranial vertebral artery stenoses: Early experience and 6-month follow-up; Die Behandlung symptomatischer extrakranieller Stenosen der Arteria vertebralis mit sirolimusbeschichteten Stents: erste Erfahrungen und Ergebnisse nach 6 Monaten

    Energy Technology Data Exchange (ETDEWEB)

    Lugmayr, H.; Kastner, M.; Froehler, W.; Meindl, S.; Zisch, R. [Krankenhaus Wels (Austria). Institut fuer Radiologie

    2004-10-01

    Purpose: To evaluate the clinical and morphological effectiveness of sirolimus-eluting stents in patients with stenoses in the extracranial vertebral artery and to assess the 6-month results. Materials and Methods: Sirolimus-eluting stents were implanted in 8 stenoses of the extracranial vertebral artery in 7 patients with symptoms of vertebrobasilar insufficiency. Seven stenoses were located at the ostium, and one further cranially in segment V 1. The mean grade diameter of the stenoses was 85.1% (60.9%-98.3%). Clinical and angiographic follow-up was performed over a period of 6 months in all patients. Results: All lesions were successfully stented with a residual stenosis of 20.2% (0.0-38.5%). Clinically, all patients showed resolution or improvement of the symptoms after stenting. After 6 months, 5 of the 8 stenoses developed intimal hyperplasia with a stenosis grade >50%. The mean measured grade of stenosis after 6 months was 56.2% (0.0-94.1%). Five patients had no clinical symptoms of a vertebrobasilar insufficiency while two had recurrent symptoms. Conclusion: Sirolimus-eluting stents in the extracranial vertebral artery have a high and unsatisfactory re-stenosis rate after 6 months. (orig.)

  9. Ascending aortic origin of a branch pulmonary artery--surgical management and long-term outcome.

    Science.gov (United States)

    Peng, Edward W K; Shanmugam, Ganesh; Macarthur, Kenneth J D; Pollock, James C S

    2004-10-01

    Ascending aortic origin of a branch pulmonary artery (AOPA, hemitruncus arteriosus) is a rare congenital malformation. While there have been isolated case reports, larger series, relating to long-term outcomes following surgery are few. This article analyses the surgical results of a series of nine patients, over a period of 29 years. Between 1974 and 2003, nine patients [neonates, 6; infants, 3; male, 5; female, 4] were operated on for AOPA. Median age at presentation was 14 days (range birth to 231 days). Six [corrected] patients (group 1) had associated simple lesions like patent ductus arteriosus or right aortic arch. Three patients (group 2) had complex lesions with right ventricular outflow tract obstruction. One patient (group 2) had DiGeorge syndrome. All patients except group 2 presented with congestive cardiac failure and, in addition one had pre-operative coronary ischemia. Diagnosis was established by angiocardiography in two patients and by echocardiography in seven [corrected] The median age at operation was 28 days (range 7-365). Follow-up period ranged from 7 months to 20.5 years (median 9 years). All nine patients had an anomalous right pulmonary artery (RPA) arising from the proximal ascending aorta, while the left branch was of right ventricular origin. All had evidence of pulmonary hypertension or elevated right ventricular pressure pre-operatively. There was no operative mortality. Of eight patients who had direct anastomosis of the RPA to the main pulmonary artery, one required patch enlargement and another required stenting of an anastomotic stenosis. One patient had a RV-RPA conduit, which required replacement 8, 13, and 14 years later. At follow-up, all patients were alive. All patients in group 1 had normal haemodynamic function and were in NYHA class I. In group 2, all were in NYHA class II with evidence of right ventricular hypertrophy. Four patients had post-operative ventilation-perfusion scans which showed satisfactory perfusion to

  10. COMPARISON OF NEW GENERIC AND ORIGINAL RAMIPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION AND HIGH CARDIOVASCULAR RISK

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    S. Yu. Martsevich

    2010-01-01

    Full Text Available Aim. To compare efficacy of ramipril generic Hartil® (Egis to original drug Tritace® in patients with arterial hypertension (HT of 1-2 degree and high cardiovascular risk, and to evaluate target blood pressure (BP achievement when taking each drug separately and in combination with the calcium channel blocker amlodipine.Material and methods. A total of 27 patients (14 men, 13 women with HT of 1-2 degree and high risk due to combination of HT with ischemic heart disease, diabetes or previous stroke were included in an open randomized crossover study. Each patient received generic and original ramipril during 6 weeks by turns. Antihypertensive efficacy (the target BP level <130/80 was evaluated every 2 weeks. In case of treatment inefficiency a dose was doubled and amlodipine (Cardilopin, Egis was added. After 6 weeks of treatment with the first drug of ramipril the second one was administered.Results. After 6-week Hartil treatment the mean systolic BP (sBP decreased by 20,0 mm Hg compared to the baseline level, while at Tritace treatment – by 22,2 mm Hg. The mean diastolic BP (dBP decreased by 10,8 and 8,6 mm Hg respectively (differences between the drugs were insignificant. Twenty patients treated with Hartil and 16 patients treated with Tritace required Cardilopin prescription. The target BP<130/80 was achieved in 10 patients (38,5% who took Hartil and in 13 patients (50% treated with the original ramipril (differences between the drugs were insignificant.Conclusion. Therapeutic equivalence of the generic ramipril Hartil and the original drug Tritace was demonstrated. Monotherapy efficacy was low in high-risk patients with HT of 1-2 degree, and combined therapy with two antihypertensive drugs was effective in 40-50% of cases.

  11. Surgical Results of Anomalous Origin of One Pulmonary Artery Branch from the Ascending Aorta.

    Science.gov (United States)

    Cho, Sungkyu; Kim, Woong-Han; Choi, Eun Seok; Lee, Jeong Ryul; Kim, Yong Jin

    2015-10-01

    We reviewed our surgical experience with anomalous origin of one pulmonary artery from the ascending aorta (AOPA). From 1989 to 2012, 12 children (five neonates) aged 3-734 days (mean 152 ± 222) with AOPA underwent operations. Eight patients had right AOPA, and four patients had left AOPA. The majority of the patients had elevated right ventricular pressure, with 58 % (7 of 12) demonstrating suprasystemic right ventricular pressure. Surgery was performed by direct anastomosis (group 1) in seven patients and by employing an autologous patch (group 2) in five patients. There were two postoperative mortalities caused by heart failure and pulmonary hypertensive crisis. The mean follow-up duration was 12.6 ± 8 years. Catheterization showed that the right ventricle-to-systemic pressure ratio decreased following operation (preoperative vs. postoperative; 1.13 ± 0.19 vs. 0.48 ± 0.03, p = 0.043). There was no difference in the perfusion of the affected lung as measured by the final lung perfusion scan, between the two groups (group 1 vs. group 2; 50.0 ± 10.3 vs. 42.7 ± 28.7 %, p = 0.158). Two patients required reoperations for pulmonary regurgitation and pulmonary artery stenosis. There were two catheter-based interventions. At 20 years, survival by the Kaplan-Meier was 91.7 ± 8.0 %, freedom from reoperation was 80.0 ± 17.9 %, and freedom from catheter intervention was 80.8 ± 12.2 %. Early repair of AOPA improves right ventricular pressure and overall hemodynamics with excellent survival and low risk of reintervention. The type of surgical repair did not significantly affect the long-term outcomes (measured via lung perfusion scan).

  12. Anomalous origin of the right coronary artery with an interarterial course and intramural part

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    Simon Fuglsang

    2015-01-01

    Conclusion: In this report, we present some unique images of the RCAs course, which contribute to the understanding of this disease’s symptomatology. The patient successfully underwent surgery with Right Internal Mammary Artery to RCA (RIMA–RCA2 RIMA–RCA = right Internal mammary artery to right coronary artery. bypass with complete remission of all symptoms.

  13. Determining origin in a migratory marine vertebrate: a novel method to integrate stable isotopes and satellite tracking

    Science.gov (United States)

    Vander Zanden, Hannah B.; Tucker, Anton D.; Hart, Kristen M.; Lamont, Margaret M.; Fujisaki, Ikuko; Addison, David S.; Mansfield, Katherine L.; Phillips, Katrina F.; Wunder, Michael B.; Bowen, Gabriel J.; Pajuelo, Mariela; Bolten, Alan B.; Bjorndal, Karen A.

    2015-01-01

    Stable isotope analysis is a useful tool to track animal movements in both terrestrial and marine environments. These intrinsic markers are assimilated through the diet and may exhibit spatial gradients as a result of biogeochemical processes at the base of the food web. In the marine environment, maps to predict the spatial distribution of stable isotopes are limited, and thus determining geographic origin has been reliant upon integrating satellite telemetry and stable isotope data. Migratory sea turtles regularly move between foraging and reproductive areas. Whereas most nesting populations can be easily accessed and regularly monitored, little is known about the demographic trends in foraging populations. The purpose of the present study was to examine migration patterns of loggerhead nesting aggregations in the Gulf of Mexico (GoM), where sea turtles have been historically understudied. Two methods of geographic assignment using stable isotope values in known-origin samples from satellite telemetry were compared: 1) a nominal approach through discriminant analysis and 2) a novel continuous-surface approach using bivariate carbon and nitrogen isoscapes (isotopic landscapes) developed for this study. Tissue samples for stable isotope analysis were obtained from 60 satellite-tracked individuals at five nesting beaches within the GoM. Both methodological approaches for assignment resulted in high accuracy of foraging area determination, though each has advantages and disadvantages. The nominal approach is more appropriate when defined boundaries are necessary, but up to 42% of the individuals could not be considered in this approach. All individuals can be included in the continuous-surface approach, and individual results can be aggregated to identify geographic hotspots of foraging area use, though the accuracy rate was lower than nominal assignment. The methodological validation provides a foundation for future sea turtle studies in the region to inexpensively

  14. Anomalous origin of the right pulmonary artery from the ascending aorta.

    Science.gov (United States)

    Prifti, Edvin; Bonacchi, Massimo; Murzi, Bruno; Crucean, Adrian; Leacche, Marzia; Bernabei, Massimo; Bartolozzi, Fabio; Nathan, Nadia S; Vanini, Vittorio

    2004-01-01

    The aim was to review our experience with the surgical repair of the anomalous origin of the right pulmonary artery (AORPA) from the aorta. Between January 1991 and March 2001, five patients with AORPA underwent surgical correction. One patient presented isolated AOPA from the aorta. Implantation of the anomalous PA to the main PA trunk was performed by (1). direct anatomosis employing an autologous pericardial patch in two patients; (2). using an aortic flap in two patients with AORPA; and (3). using an aortic and pulmonary flaps in another patient. The mean follow-up time was 27 months. One patient died due to progressive heart failure unresponsive to inotropic support. Early postoperative pulmonary hypertension crisis was identified in patient 4, that was managed by intravenous prostacyclin. The same patient necessitated mechanical ventilation for 11 days. The mean residual gradient for all survivors was 9.5 +/- 4 mmHg. The postoperative Tc-99 m scintigraphy demonstrated 72 +/- 4.5(%) lung perfusion. At follow-up the survival was 100%. None of the followed patients required reoperation. The AORPA from the aorta is a rare but important entity, necessitating a scrupulous preoperative and intraoperative evaluation. The techniques employing autologous tissues for enlarging and lengthening the AORPA seem to be associated with better results in terms of postoperative restenosis.

  15. Catheter-based anatomic and functional assessment of coronary arteries in anomalous aortic origin of a coronary artery, myocardial bridges and Kawasaki disease.

    Science.gov (United States)

    Qureshi, Athar M; Agrawal, Hitesh

    2017-09-01

    Most diagnostic testing in patients with anomalous aortic origins of coronary arteries, myocardial bridges, and coronary artery changes after Kawasaki disease are performed with the use of noninvasive techniques. In some cases, however, further diagnostic information is needed to guide the clinician in treating these patients. In such instances, cardiac catheterization with invasive anatomic and functional testing is an invaluable tool. Moreover, interventional treatment in the cardiac catheterization laboratory may be performed in a small subset of these patients. As the diagnosis of these conditions is now becoming more common, it is important for pediatric interventional cardiologists to be familiar with these techniques. In this article, the role of angiography, intravascular ultrasound, fractional flow reserve, and optical coherence tomography in these patients is reviewed. © 2017 Wiley Periodicals, Inc.

  16. Clinical and radiographic outcomes following traumatic Grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.

    Science.gov (United States)

    Scott, William W; Sharp, Steven; Figueroa, Stephen A; Eastman, Alexander L; Hatchette, Charles V; Madden, Christopher J; Rickert, Kim L

    2015-05-01

    Proper screening, management, and follow-up of Grade 1 and 2 blunt carotid artery injuries (BCIs) remains controversial. These low-grade BCIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral artery injuries treated between August 2003 and April 2013 was performed and Grade 1 and 2 BCIs were identified. Grade 1 injuries are defined as a vessel lumen stenosis of less than 25%, and Grade 2 injuries are defined as a stenosis of the vessel lumen between 25% and 50%. Demographic information, radiographic imaging, number of imaging sessions performed per individual, length of radiographic follow-up, radiographic outcome at end of follow-up, treatment(s) provided, and documentation of ischemic stroke or transient ischemic attack were recorded. One hundred seventeen Grade 1 and 2 BCIs in 100 patients were identified and available for follow-up. The mean follow-up duration was 60 days. Final imaging of Grade 1 and 2 BCIs demonstrated that 64% of cases had resolved, 13% of cases were radiographically stable, and 9% were improved, whereas 14% radiographically worsened. Of the treatments received, 54% of cases were treated with acetylsalicylic acid (ASA), 31% received no treatment, and 15% received various medications and treatments, including endovascular stenting. There was 1 cerebral infarction that was thought to be related to bilateral Grade 2 BCI, which developed soon after hospital admission. The majority of Grade 1 and 2 BCIs remained stable or improved at final follow-up. Despite a 14% rate of radiographic worsening in the Grade 1 and 2 BCIs cohort, there were no adverse clinical outcomes associated with these radiographic changes. The stroke rate was 1% in this low-grade BCIs cohort, which may be an overestimate. The use of ASA or other antiplatelet or anticoagulant

  17. Successful neo-ostium creation using pulmonary artery tissue in a case of anomalous origin of the left coronary artery from the right sinus of Valsalva.

    Science.gov (United States)

    Kumagai, Kazuya; Kin, Hajime; Ikai, Akio; Okabayashi, Hitoshi

    2014-05-01

    Anomalous origin of the left coronary artery (LCA) from the right sinus of Valsalva is rare and is known to cause sudden death in young patients. A 17-year old male patient experienced syncopal episodes after intense exercise. No abnormal findings were noted on brain magnetic resonance imaging, electroencephalography or Holter monitoring. Contrast-enhanced coronary computed tomography revealed the anomalous origin of the LCA from the right sinus of Valsalva. Considering the positional relationship with the aortic valve and the morphology of the left main trunk, a neo-ostium was created in the left coronary sinus, and patch angioplasty was performed using pulmonary arterial wall tissue. The postoperative course of the patient was uneventful, and the patient remains asymptomatic 2 years after surgery. Here, we describe this case and review the literature on the different surgical techniques for this anomaly. We believe that our technique would be useful in cases of anomalous origin of the LCA from the right sinus of Valsalva, regardless of morphological variations.

  18. Anomalous origin of the left coronary artery from the pulmonary trunk. Clinical features and midterm results after surgical treatment

    Directory of Open Access Journals (Sweden)

    Amaral Fernando

    1999-01-01

    Full Text Available OBJECTIVE: To report the authors' experience with the anomalous origin of the left coronary artery (AOLCA from the pulmonary trunk, emphasizing preoperative data, surgical aspects and midterm results of the follow-up. METHODS: Retrospective analysis of 11 patients operated upon at the Royal Brompton Hospital from October, 84 to April, 97. RESULTS: Nine infants had heart failure (HF and two other children presented with dyspnea and chest pain. All had ECG changes. The echocardiogram identified the anomalous origin of the coronary artery in 7 (64% patients and hemodynamic studies were performed in 7 patients. All infants were operated upon between the 2nd and 10th month of life. Six patients were treated with aortic reimplantation of the left coronary artery, whereas five were operated upon according to the Takeuchi technique. All patients are alive, with clear improvement of the ECG changes and ventricular function, as evaluated by echocardiography. Two patients operated upon according to the Takeuchi technique required additional surgery due to severe supravalvular pulmonary stenosis. CONCLUSION: AOLCA is a rare disease. Most patients show early signs of severe HF associated with ECG findings. Surgical therapy must be instituted early in the disease, preferentially through aortic implantation of the anomalous coronary artery, with a high possibility of success. Shortly after surgery, clinical and ECG improvement, as well as normalization of left ventricular function, should be expected.

  19. Late Diagnosis of Anomalous Aortic Origin of a Coronary Artery from the Inappropriate Sinus of Valsalva during Investigation of Chest Pain

    Directory of Open Access Journals (Sweden)

    Brunna Priscylla Américo Carvalho

    2018-01-01

    Full Text Available In this work are reported two cases of anomalous aortic origin of a coronary artery (AAOCA, with the left main coronary artery (LMCA arising at the right sinus of Valsalva in a 77-year-old woman and in a 79-year-old man submitted to angiography after positive ischemic tests. The origin of the LMCA or the left descendant artery (LDA from the right sinus of Valsalva has a prevalence of 0.2%, the origin of the circumflex artery (CXA from the right sinus 0.5%, and the origin of the right coronary artery (RCA from the left sinus of Valsalva has a prevalence of 0.3%. It is the subgroup of the coronary anomalies that has the greatest potential for clinical repercussions, especially the sudden cardiac death (SCD. We discuss the diagnostic methods and treatment options for this kind of coronary anomaly in symptomatic cases.

  20. Anomalous Origin of the Right Pulmonary Artery From the Ascending Aorta in a 10-Month-Old Child

    Directory of Open Access Journals (Sweden)

    Pedro Pallangyo MD, MPH

    2016-05-01

    Full Text Available Anomalous origin of the right pulmonary artery from the ascending aorta is a rare congenital deformity associated with poor quality of life and reduced life expectancy. Without a corrective surgery, less than one third of cases will live to see their sixth month. We report a case of a 10-month-old male child from Tanzania who presented with a 6-month history of recurrent respiratory tract infections, mild effort intolerance, and failure to thrive.

  1. Anomalous Origin of the Right Pulmonary Artery From the Ascending Aorta in a 10-Month-Old Child

    Science.gov (United States)

    Pallangyo, Pedro; Lyimo, Frederick; Nicholaus, Paulina; Mtolera, Maria

    2016-01-01

    Anomalous origin of the right pulmonary artery from the ascending aorta is a rare congenital deformity associated with poor quality of life and reduced life expectancy. Without a corrective surgery, less than one third of cases will live to see their sixth month. We report a case of a 10-month-old male child from Tanzania who presented with a 6-month history of recurrent respiratory tract infections, mild effort intolerance, and failure to thrive. PMID:27231696

  2. Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease.

    Science.gov (United States)

    Gräni, Christoph; Benz, Dominik C; Schmied, Christian; Vontobel, Jan; Mikulicic, Fran; Possner, Mathias; Clerc, Olivier F; Stehli, Julia; Fuchs, Tobias A; Pazhenkottil, Aju P; Gaemperli, Oliver; Buechel, Ronny R; Kaufmann, Philipp A

    2017-02-01

    Anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) are associated with adverse cardiac events. Discrimination between ACAOS and coronary artery disease (CAD)-related perfusion defects may be difficult. The aim of the present study was to investigate the value of hybrid coronary computed tomography angiography (CCTA)/SPECT-MPI in patients with ACAOS and possible concomitant CAD. We retrospectively identified 46 patients (mean age 56 ± 12 years) with ACAOS revealed by CCTA who underwent additional SPECT-MPI. ACAOS with an interarterial course were classified as malignant, whereas all other variants were considered benign. CCTA/SPECT-MPI hybrid imaging findings (ischemia or scar) were analyzed according to the territory subtended by an anomalous vessel or a stenotic coronary artery. Twenty-six (57%) patients presented with malignant ACAOS. Myocardial ischemia or scar was found only in patients who had concomitant obstructive CAD in the vessel matching the perfusion defect as evidenced by hybrid CCTA/SPECT imaging. Hybrid CCTA/SPECT-MPI represents a valuable non-invasive tool to discriminate the impact of ACAOS from concomitant CAD on myocardial ischemia. Our results suggest that in a middle-aged population myocardial ischemia due to ACAOS per se may be exceedingly rare and is more likely attributable to concomitant CAD.

  3. Clinical and radiographic outcomes following traumatic Grade 3 and 4 carotid artery injuries: a 10-year retrospective analysis from a Level 1 trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.

    Science.gov (United States)

    Scott, William W; Sharp, Steven; Figueroa, Stephen A; Eastman, Alexander L; Hatchette, Charles V; Madden, Christopher J; Rickert, Kim L

    2015-03-01

    Screening, management, and follow-up of Grade 3 and 4 blunt carotid artery injuries (BCAIs) remain controversial. These high-grade BCAIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and cerebral infarction. A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral artery injuries from August 2003 to April 2013 was performed, and Grade 3 and 4 BCAIs were identified. The authors define Grade 3 injuries as stenosis of the vessel greater than 50%, or the development of a pseudoaneurysm, and Grade 4 injuries as complete vessel occlusion. Demographic information, imaging findings, number of images obtained per individual, length of radiographic follow-up examination, radiographic outcome at end of follow-up period, treatment(s), and documentation of ischemic stroke or transient ischemic attack (TIA) were recorded. Fifty-three Grade 3 BCAIs in 44 patients and 5 Grade 4 BCAIs in 5 patients were identified and had available follow-up information. The mean follow-up duration for Grade 3 BCAIs was 113 days, and the mean follow-up for Grade 4 BCAIs was 78 days. Final imaging of Grade 3 BCAIs showed that 53% of cases were radiographically stable, 11% had resolved, and 11% were improved, whereas 25% had radiographically worsened. In terms of treatment, 75% of patients received aspirin (ASA) alone, 5% received various medications, and 2% received no treatment. Eighteen percent of the patients in the Grade 3 BCAI group underwent endovascular intervention, and in all of these cases, treatment with ASA was continued after the procedure. Final imaging of the Grade 4 BCAIs showed that 60% remained stable (with persistent occlusion), whereas the remaining arteries improved (with recanalization of the vessel). All patients in the Grade 4 BCAI follow-up group were treated with ASA, although in 1 patient treatment was transitioned to Coumadin. There were 3 cases of

  4. The cristal (right superior septal) coronary artery and its relationship to anomalous left coronary origin.

    Science.gov (United States)

    Partridge, J B; Ridley, L J

    2011-10-01

    The cristal artery is an occasional finding, being visible in around 3% of coronary angiograms, arising from the proximal right coronary artery (RCA) and passing downwards and forwards through the muscle of the crista superventricularis. It supplies a variable volume of the superior interventricular septum, and can contribute to collateralization of the other septal vessels. When part or all of the left coronary artery (LCA) arises anomalously from the right coronary sinus, its passage to the left may be in the same pathway as a cristal artery, bearing a tell-tale septal vessel arising from its proximal segment. This helps to differentiate it from one that has a higher pathway, running between the great vessels, and which may have a greater correlation with sudden cardiac death. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  5. Permanent Cortical Blindness After Bronchial Artery Embolization

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    Doorn, Colette S. van, E-mail: cvandoorn@gmail.com; De Boo, Diederick W., E-mail: d.w.deboo@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands); Weersink, Els J. M., E-mail: e.j.m.weersink@amc.uva.nl [Academic Medical Centre, Department of Pulmonology (Netherlands); Delden, Otto M. van, E-mail: o.m.vandelden@amc.uva.nl; Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Lienden, Krijn P. van, E-mail: k.p.vanlienden@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands)

    2013-12-15

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  6. An investigation of the origin, location and variations of the renal arteries in human fetuses and their clinical relevance.

    Science.gov (United States)

    Ciçekcibaşi, Aynur Emine; Ziylan, Taner; Salbacak, Ahmet; Seker, Muzaffer; Büyükmumcu, Mustafa; Tuncer, Işik

    2005-09-01

    We investigated the origin, localizations and anatomic variations of the renal artery (RA) in human fetuses with the aim of determining the distribution of these variations according to lateralization and gender. In total, 90 fetuses of spontaneous abortion (45 males, 45 females) with no congenital malformations were included to the study. The abdominal aorta and its branches were dissected after latex solution colored with red ink had been injected into the vessels from the thoracic aorta. In all, 180 RA dissections were performed bilaterally in 90 cases and the anatomic variations were photographed. Right and left RAs were found to originate from the following levels according to the columna vertebralis, respectively: 3.8% and 1.9% lower T12, 67.3% and 25.0% upper L1, 9.6% and 28.8% mid L1, 15.3% and 40.3 lower L1, 3.8% and 3.8% upper 1/3 part of L2 vertebra. The right RA originated from the lateral part and anterolateral wall of the abdominal aorta in 73.0% and 26.9% of cases while the lateral and anterolateral wall origin percentages of left RA were 90.3% and 9.6%, respectively. The origin site of the right RA from the abdominal aorta was superior to, at the same level with, and inferior to that of the left RA in 53.8%, 34.6% and 11.5% of the cases, respectively. There were no variations in 75% of the cases whereas the remaining 25% had several variation patterns. The presented morphological results are as follows: A single hilar artery in 75% of the cases, double hilar arteries in 11.1%, an inferior polar artery in 10.5%, and a superior polar artery in 3.3% of specimens studied. Anatomical variations were observed more frequently among male fetuses and on the right side. Knowledge of RA variations is important for surgeons in performing many procedures and may help to avoid clinical complications, especially, during radiological examination and/or surgical approaches in the abdominal region.

  7. Postoperative outcome in patients with anomalous origin of one pulmonary artery branch from the aorta.

    Science.gov (United States)

    Prifti, Edvin; Crucean, Adrian; Bonacchi, Massimo; Bernabei, Massimo; Leacche, Marzia; Murzi, Bruno; Bartolozzi, Fabio; Vanini, Vittorio

    2003-07-01

    The aim was to review our experience with the surgical repair of the anomalous origin of one pulmonary branch from the aorta (AOPA). Between January 1991 and March 2002, eight patients with AOPA underwent surgical correction. Three patients presented isolated AOPA. Five patients presented right AOPA and three, left AOPA. Implantation of the AOPA to the main pulmonary artery was performed by: (I) direct anastomosis in two patients with left AOPA; (II) interposition of a synthetic graft in one patient with left AOPA; (III) employing an autologous pericardial patch in two patients with right AOPA; (IV) using an aortic flap in three other patients with right AOPA. The mean follow-up time was 37.7 months. One patient died postoperatively due to progressive heart failure unresponsive to inotropic support. Early postoperative pulmonary hypertension crisis was identified in another patient. Within 1 year after surgery, the mean residual gradient across the anastomotic site at follow-up was 14+/-8 mmHg. The patient undergoing interposition of a synthetic graft presented a residual gradient of 29 mmHg and underwent reoperation at almost 2.5 years after the first correction. The residual gradient in patients undergoing correction according to technique I was 17+/-3 mmHg, and in patients undergoing implantation of the AOPA according to techniques III or IV was 9.5+/-4.6 mmHg (P=0.11). Similarly, the Tc-99m scintigraphy demonstrated that a lower lung perfusion (the lung perfused from the respective AOPA compared with the contralateral lung) in patients undergoing AOPA implantation according to technique I was 59+/-6(%) and in patients undergoing techniques III or IV was 72+/-4.5(%) (P=0.038). At follow-up, all patients were alive. The AOPA from the aorta is a rare but important entity, necessitating a scrupulous preoperative and intraoperative evaluation. Patients presenting this anomaly may undergo correction using various surgical techniques with acceptable results. The

  8. Concomitant origin of the anterior or posterior spinal artery with the feeder of a spinal dural arteriovenous fistula (SDAVF).

    Science.gov (United States)

    Adrianto, Yudhi; Yang, Ku Hyun; Koo, Hae-Won; Park, Wonhyoung; Jung, Sung Chul; Park, Jie Eun; Kim, Kwang-Kuk; Jeon, Sang Ryong; Suh, Dae Chul

    2017-04-01

    The concomitant origin of the anterior spinal artery (ASA) or the posterior spinal artery (PSA) from the feeder of a spinal dural arteriovenous fistula (SDAVF) is rare and the exact incidence is not known. We present our experience with the management of SDAVFs in such cases. In 63 patients with SDAVF between 1993 and 2015, the feeder origin of the SDAVF was evaluated to determine whether it was concomitant with the origin of the ASA or PSA. Embolization was attempted when the patient did not want open surgery and an endovascular approach was regarded as safe and possible. The outcome of the procedure was evaluated as complete, partial, or no obliteration. The clinical outcome was evaluated by Aminoff-Logue (ALS) gait and micturition scale scores. Nine patients (14%) had a concomitant origin of the ASA or PSA with the feeder. There were two cervical, five thoracic, and two lumbar level SDAVFs. A concomitant origin of the feeder was identified with the ASA (n=7) and PSA (n=2). Embolization was performed in four patients and open surgery was performed in five. Embolization resulted in complete obliteration in three patients and partial obliteration in one. Using the ALS gait and micturition scale, the final outcome improved in six while three cases remained in an unchanged condition over 2-148 months. The concomitant origin of the ASA or PSA with the feeder occurs occasionally. Complete obliteration of the fistula can be achieved either by embolization or open surgery. Embolization can be carefully performed in selected patients who are in a poor condition and do not want to undergo open surgery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. A case of anomalous origin of the left coronary artery presenting with ...

    African Journals Online (AJOL)

    He was inconsolable, had marked respiratory distress, cool extremities, central and peripheral cyanosis oxygen. The radial and brachial pulses were absent. The mean arterial pressure was 65mmHg, Heart rate of 160 beats per minute with a third heart sound. The liver was enlarged 4cm below the costal margin and tender, ...

  10. Origem anômala da artéria circunflexa da artéria pulmonar direita Anomalous origin of circunflex artery from the right pulmonary artery

    Directory of Open Access Journals (Sweden)

    José Carlos R Iglézias

    1989-08-01

    Full Text Available É relatado, pela primeira vez na literatura, o caso de paciente adulto de 35 anos, com queixa de dor precordial aos esforços desde há 17 anos e que, após ter sido submetido a correção de coarctação de aorta, foi investigado e teve como diagnóstico: origem anômala da artéria circunflexa. No intra-operatório, constatou-se que a mesma tinha origem na artéria pulmonar direita. Foi realizada a sutura do óstio anômalo e um enxerto livre da artéria torácica interna direita para a coronária circunflexa. Além da raridade da lesão, são possíveis considerações fisiopatológicas relacionadas com a coarctação da aorta, neste caso específico.A case never described in adults before is here reported. A 35-year-old patient who had referred precordial pain in effort for seventeen years was investigated after having been submitted to correction of coarctation of the aorta, and had the following diagnosis: anomalous origin of the circunflex artery. In the intraoperatory, the latter was found to proceeed from the right pulmonary artery. The anomalous ostio was sutured and a free graft was made, from the right internal thoracic artery to the circunflex coronary. In addition to the unusualness of such pathology, some physiopatologic considerations related to the coarctation of the aorta may be made, in this particular case.

  11. The anatomical origin and course of the angular artery regarding its clinical implications.

    Science.gov (United States)

    Kim, Yi-Suk; Choi, Da-Yae; Gil, Young-Chun; Hu, Kyung-Seok; Tansatit, Tanvaa; Kim, Hee-Jin

    2014-10-01

    The purposes of this study were to determine the morphological features and conceptualize the anatomical definition of the angular artery (AA) as an aid to practical operations in the clinical field. Thirty-one hemifaces from 17 Korean cadavers and 26 hemifaces from 13 Thai cadavers were dissected. The topography of the AA was classified into 4 types according to its course: Type I (persistent pattern), in which the AA traverses the lateral side of the nose (11%); Type II (detouring pattern), in which the AA traverses the cheek and tear trough area (18%); Type III (alternative pattern), in which the AA traverses the medial canthal area through a branch of the ophthalmic artery (22.8%); and Type IV (latent pattern), in which the AA is absent (26.3%). The findings of this study will contribute toward improved outcomes for cosmetic surgery involving the injection of facial filler by enhancing the understanding of AA anatomy.

  12. Vertebral chondroblastoma

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    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States); Unni, Krishnan K. [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905 (United States)

    2003-02-01

    To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral

  13. COMBINATION OF AMPLATZER VASCULAR PLUG 4 IN OCCLUSION OF THE LEFT VERTEBRAL ARTERY, WITH MICROSPHERES PLUS COILS FOR EMBOLIZATION OF THE DEEP CERVICAL BRANCHES FOR PRESURGICAL TREATMENT OF A HYPERVASCULAR C-5 METASTASIS: CASE REPORT AND REVIEW OF THE LITERATURE

    Directory of Open Access Journals (Sweden)

    Antonio Basile

    2017-05-01

    Full Text Available Clinical use of Amplatzer Vascular Plug in central and peripheral vascular system has been extensively described in the literature. We present a case of occlusion of left vertebral artery (LVA performed by deploying an Amplatzer Vascular Plug, in addition to microspheres plus coils for embolization of the deep cervical branches that feed a cervical metastasis involving the left VA. After the endovascular intervention, the patient underwent surgical resection of the lesion. The application of the device, the use of multiple embolic materials, as well as the angiographic and clinical results of the procedure, were evaluated because not previously reported in the literature. Hence, we provide an updated literature review about clinical use of Amplatzer Vascular Plug in supra-aortic vessels.

  14. The origin of the auriculotemporal nerve and its relationship to the middle meningeal artery.

    Science.gov (United States)

    Dias, George J; Koh, Joshua M C; Cornwall, Jon

    2015-09-01

    Knowledge of the anatomy of the auriculotemporal nerve (ATN) and middle meningeal artery (MMA) in the infratemporal fossa is necessary for assisting concise medical diagnosis and intervention. Current textbook descriptions describe a relationship between these structures that is not reported in previous studies. In addition, no previous studies have reported on symmetry or ethnicity affecting the relationship between these structures. This study aims to provide information on the relationship between the ATN and the meningeal artery in a specific ethnic group to further our understanding of normal morphology in this region. The infratemporal fossae of 19 Caucasian cadaveric heads were dissected bilaterally and the relationship between the ATN and MMA scrutinised. Twenty-five samples were included for analysis, including 6 bilateral (12 sides, 8 female) and 13 unilateral (9 female) specimens. Nerve root contributions to the ATN from the mandibular and inferior alveolar nerve included 8 specimens with 1 root, 12 with 2, 5 with 3, and 1 with 4. Three of six bilaterally dissected specimens had asymmetrical numbers of nerve roots. Two specimens were found with a 'button hole' arrangement of the ATN; these did not enclose the MMA. Variation was found both between and within specimens in relation to the relationship between the ATN and MMA. None of the specimens examined demonstrated a morphology that was consistent with common anatomical texts. Findings suggest modern texts require revision in order to accurately describe the relationship between these structures.

  15. The origins of the vertebrate hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-thyroid (HPT) endocrine systems: new insights from lampreys.

    Science.gov (United States)

    Sower, Stacia A; Freamat, Mihael; Kavanaugh, Scott I

    2009-03-01

    The acquisition of a hypothalamic-pituitary axis was a seminal event in vertebrate evolution leading to the neuroendocrine control of many complex functions including growth, reproduction, osmoregulation, stress and metabolism. Lampreys as basal vertebrates are the earliest evolved vertebrates for which there are demonstrated functional roles for two gonadotropin-releasing hormones (GnRHs) that act via the hypothalamic-pituitary-gonadal axis controlling reproductive processes. With the availability of the lamprey genome, we have identified a novel GnRH form (lamprey GnRH-II) and a novel glycoprotein hormone receptor, lGpH-R II (thyroid-stimulating hormone-like receptor). Based on functional studies, in situ hybridization and phylogenetic analysis, we hypothesize that the newly identified lamprey GnRH-II is an ancestral GnRH to the vertebrate GnRHs. This finding opens a new understanding of the GnRH family and can help to delineate the evolution of the complex neuro/endocrine axis of reproduction. A second glycoprotein hormone receptor (lGpH-R II) was also identified in the sea lamprey. The existing data suggest the existence of a primitive, overlapping yet functional HPG and HPT endocrine systems in this organism, involving one possibly two pituitary glycoprotein hormones and two glycoprotein hormone receptors as opposed to three or four glycoprotein hormones interacting specifically with three receptors in gnathostomes. We hypothesize that the glycoprotein hormone/glycoprotein hormone receptor systems emerged as a link between the neuro-hormonal and peripheral control levels during the early stages of gnathostome divergence. The significance of the results obtained by analysis of the HPG/T axes in sea lamprey may transcend the limited scope of the corresponding physiological compartments by providing important clues in respect to the interplay between genome-wide events (duplications), coding sequence (mutation) and expression control level evolutionary mechanisms

  16. The value of transthoracic echocardiography in the diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta: A single center experience from China.

    Science.gov (United States)

    Wang, Jing; Song, Yue; Cheng, Tsung O; Xie, Mingxing; Wang, Xinfang; Yuan, Li; Yang, Yali; Wang, Lei

    2015-04-01

    Anomalous origin of pulmonary artery (AOPA) from the ascending aorta is a rare but serious congenital cardiac malformation, which frequently involves the right pulmonary artery (RPA). We retrospectively analyzed the echocardiographic characteristics of 9 cases with anomalous origin of the right pulmonary artery from the ascending aorta (AORPA) studied from 2007 to 2014 in our institution. The results were compared with the findings at surgery. The corrective surgery was performed in all 9 cases with AORPA. The diagnosis by transthoracic echocardiography (TTE) of 8 cases with AORPA was confirmed at surgery. The coincidence rate for TTE and surgical findings was 88.9%. One case was misdiagnosed as anomalous origin of the left pulmonary artery from the ascending aorta. The anomalous RPA in all cases had a proximal origin from the posterior or lateral part of the ascending aorta in our series. The mean distance from the aortic valve to the site of origin of pulmonary artery was 16.1 ± 6.6 mm (range: 7.0 mm-24.0 mm). The mean diameter of the anomalous pulmonary artery was 9.6 ± 4.5 mm (range: 4.5 mm-17.0 mm). In 4 of 9 (44.5%) cases there were associated aortopulmonary septal defect, intact ventricular septum, patent ductus arteriosus and interruption of aortic arch (Type A), also known as the Berry's syndrome. Other associated cardiovascular abnormalities included patent ductus arteriosus, ventricular septal defect and atrial septal defect. Severe pulmonary arterial hypertension was noted in all cases. TTE plays an important role in the non-invasive and accurate diagnosis of AORPA. TTE can clearly display its site of origin and course, as well as other associated malformations and hemodynamic changes. TTE also plays an important role in the preoperative diagnosis of AORPA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Anomalous origin of the left coronary artery arising from the pulmonary trunk: report of an adult case with long-term follow-up after surgery

    Energy Technology Data Exchange (ETDEWEB)

    Mesurolle, B.; Qanadli, S.D.; Mignon, F.; Lacombe, P. [Department of Radiology, Hopital Ambroise Pare, Boulogne-Billancourt (France); Merad, M. [Dept. of Medicine, Institut Gustave-Roussy, Villejuif (France); Dubourg, O. [Dept. of Cardiology, Hopital Ambroise Pare, Boulogne-Billancourt (France)

    1999-10-01

    An anomalous origin of the left coronary artery arising from the pulmonary artery is a congenital malformation rarely described in adults. We report the case of a 65-year-old patient with this anomaly. Clinical presentation, imaging identification (coronary angiogram, MRI and electron-beam CT), surgical treatment and angiographic long-term follow-up are described. (orig.) With 5 figs., 17 refs.

  18. Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial.

    Science.gov (United States)

    Halkes, P H A; van Gijn, J; Kappelle, L J; Koudstaal, P J; Algra, A

    2007-02-01

    Oral anticoagulants are better than aspirin for secondary prevention after myocardial infarction and after cerebral ischaemia in combination with non-rheumatic atrial fibrillation. The European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) aimed to determine whether oral anticoagulation with medium intensity is more effective than aspirin in preventing future vascular events in patients with transient ischaemic attack or minor stroke of presumed arterial origin. In this international, multicentre trial, patients were randomly assigned within 6 months after a transient ischaemic attack or minor stroke of presumed arterial origin either anticoagulants (target INR range 2.0-3.0; n=536) or aspirin (30-325 mg daily; n=532). The primary outcome was the composite of death from all vascular causes, non-fatal stroke, non-fatal myocardial infarction, or major bleeding complication, whichever occurred first. In a post hoc analysis anticoagulants were compared with the combination of aspirin and dipyridamole (200 mg twice daily). Treatment was open, but auditing of outcome events was blinded. Primary analysis was by intention to treat. This study is registered as an International Standard Randomised Controlled Trial (number ISRCTN73824458) and with ClinicalTrials.gov (NCT00161070). The anticoagulants versus aspirin comparison of ESPRIT was prematurely ended because ESPRIT reported previously that the combination of aspirin and dipyridamole was more effective than aspirin alone. Mean follow-up was 4.6 years (SD 2.2). The mean achieved INR was 2.57 (SD 0.86). A primary outcome event occurred in 99 (19%) patients on anticoagulants and in 98 (18%) patients on aspirin (hazard ratio [HR] 1.02, 95% CI 0.77-1.35). The HR for ischaemic events was 0.73 (0.52-1.01) and for major bleeding complications 2.56 (1.48-4.43). The HR for the primary outcome event comparing anticoagulants with the combination treatment of aspirin and dipyridamole was 1.31 (0.98-1.75). Oral

  19. Infundibular dilation and aneurysm at the origin of the posterior communicating artery: differential diagnosis by CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Min, Kyung-Jun; Yoon, Dae-Young [Hallym University College of Medicine, Department of Radiology, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of); Kim, Heung-Chul [Hallym University College of Medicine, Department of Radiology, Chuncheon Sacred Heart Hospital, Chuncheon (Korea, Republic of); Lee, Jong-Young; Cho, Byung-Moon [Hallym University College of Medicine, Department of Neurosurgery, Kangdong Seong-Sim Hospital, Seoul (Korea, Republic of)

    2014-11-15

    Infundibular dilation (ID) and aneurysm at the internal carotid artery (ICA)-posterior communicating artery (PComA) junction can be difficult to distinguish but may differ in clinical significance. The aim of this study was to evaluate the utility of CT angiography (CTA) in differentially diagnosing IDs and small unruptured aneurysms at the ICA-PComA junction. This retrospective study comprised 88 patients diagnosed with 107 protrusions (70 IDs and 37 aneurysms <5 mm; 19 bilateral lesions) at the ICA-PComA junction who underwent both CTA and digital subtraction angiography (DSA). Two neuroradiologists independently reviewed CTA and DSA images according to these criteria: (a) size (maximum dimension <3 or ≥3 mm), (b) shape (triangular or round/oval/irregular), (c) aneurysmal neck (absent or present), (d) horizontal direction (posteriomedial or posteriolateral), and (e) PComA origin (apex, no PComA, or base). The intermodality (between CTA and DSA) and interobserver (between the two readers) agreement were determined for each finding. We also evaluated the sensitivity and specificity of CTA for distinguishing ID and aneurysm, using DSA as the reference standard. The mean κ values of intermodality agreement for the size, shape, aneurysmal neck, horizontal direction, and PComA origin were 0.88, 0.87, 0.84, 0.71, and 0.56, respectively. All interobserver agreements of CTA and DSA were excellent. The sensitivity, specificity, and accuracy of CTA for differentiating aneurysms from IDs were 94.6, 100, and 98.0 %, respectively. CTA may be a useful noninvasive modality for differential diagnosis of ID and aneurysm at the ICA-PComA junction. (orig.)

  20. High incidence of ICA anterior wall aneurysms in patients with an anomalous origin of the ophthalmic artery: possible relevance to the pathogenesis of aneurysm formation.

    Science.gov (United States)

    Indo, Masahiro; Oya, Soichi; Tanaka, Michihiro; Matsui, Toru

    2014-01-01

    Surgery for aneurysms at the anterior wall of the internal carotid artery (ICA), which are also referred to as ICA anterior wall aneurysms, is often challenging. A treatment strategy needs to be determined according to the pathology of the aneurysm-namely, whether the aneurysm is a saccular aneurysm with firm neck walls that would tolerate clipping or coiling, a dissecting aneurysm, or a blood blister-like aneurysm. However, it is not always possible to properly evaluate the condition of the aneurysm before surgery solely based on angiographic findings. The authors focused on the location of the ophthalmic artery (OA) in determining the pathology of ICA anterior wall aneurysms. Between January 2006 and December 2012, diagnostic cerebral angiography, for any reason, was performed on 1643 ICAs in 855 patients at Saitama Medical Center. The authors also investigated the relationship between the origin of the OA and the incidence of ICA anterior wall aneurysms. The pathogenesis was also evaluated for each aneurysm based on findings from both angiography and open surgery to identify any correlation between the location where the OA originated and the conditions of the aneurysm walls. Among 1643 ICAs, 31 arteries (1.89%) were accompanied by an anomalous origin of the OA, including 26 OAs originating from the C3 portion, 3 originating from the C4 portion, and 2 originating from the anterior cerebral artery. The incidence of an anomalous origin of the OA had no relationship to age, sex, or side. Internal carotid artery anterior wall aneurysms were observed in 16 (0.97%) of 1643 ICAs. Female patients had a significantly higher risk of having ICA anterior wall aneurysms (p = 0.026). The risk of ICA anterior wall aneurysm formation was approximately 50 times higher in patients with an anomalous origin of the OA (25.8% [8 of 31]) than in those with a normal OA (0.5% [8 of 1612], p ICA anterior wall aneurysms underwent craniotomies. Based on the intraoperative findings, all 6

  1. Perchance to dream? Primordial motor activity patterns in vertebrates from fish to mammals: their prenatal origin, postnatal persistence during sleep, and pathological reemergence during REM sleep behavior disorder.

    Science.gov (United States)

    Corner, Michael A; Schenck, Carlos H

    2015-12-01

    An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals (i.e. birds and mammals) continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as 'rapid-BODY-movement' (RBM) sleep. The term 'rapid-EYE-movement (REM) sleep', characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with 'paradoxical arousal' of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded (as many prematurely have) that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as 'REM sleep behavior disorder (RBD)', which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.

  2. [Absent pulmonary valve syndrome with ductal origin of the left pulmonary artery. Diagnosis only by 2-D echo doppler color flow mapping].

    Science.gov (United States)

    Cazzaniga, M; Rico Gómez, F; Ros Pérez, P; Quero Jiménez, C; Rodríguez Vázquez del Rey, M

    2000-01-01

    A two-month old infant is described with the rare combination of absent pulmonary valve syndrome, ventricular septal defect, pulmonar "anular" stenosis and ductal origin of the left pulmonary artery. The diagnosis that was confirmed in the operating room was made by 2-D echocardiographic Doppler color flow mapping study without the support of cardiac catheterization.

  3. Anomalous origin of one pulmonary artery from the ascending aorta (hemitruncus) in a premature infant: a case report and literature review.

    Science.gov (United States)

    Bi, Wenjing; Ren, Weidong; Song, Guang; Shang, Cong; Pan, Fuzhi; Xu, Min

    2014-01-01

    Anomalous origin of one pulmonary artery from the aorta (AOPA) is a rare congenital anomaly. Here, we report the case of a premature infant with a delayed diagnosis of AOPA who died before surgical repair could be attempted, and we review the literature regarding the diagnosis and surgical approaches in premature infants with AOPA. © 2013 Wiley Periodicals, Inc.

  4. Superdominant Right Coronary Artery with Absence of Left Circumflex and Anomalous Origin of the Left Anterior Descending Coronary from the Right Sinus: An Unheard Coronary Anomaly Circulation

    Directory of Open Access Journals (Sweden)

    Marcos Danillo Peixoto Oliveira

    2015-01-01

    Full Text Available Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. We present herein the case of a 70-year-old man with symptomatic severe aortic valvar stenosis whose preoperative coronary angiogram revealed a so far unreported coronary anomaly circulation pattern.

  5. Multiple vertebral fluid-fluid levels

    Energy Technology Data Exchange (ETDEWEB)

    Bladt, O.; Demaerel, P.; Catry, F.; Breuseghem, I. Van [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Ballaux, F. [University Hospitals Gasthuisberg, Department of Pathology, Leuven (Belgium); Samson, I. [University Hospitals Gasthuisberg, Department of Orthopedic Surgery, Leuven (Belgium)

    2004-11-01

    We present a case of multiple vertebral metastases, with multiple fluid-fluid levels, from a moderately to poorly differentiated carcinoma of unknown origin. We suggest that fluid-fluid levels in multiple vertebral lesions are highly suggestive of bone metastases. (orig.)

  6. Anomalous left coronary artery from the pulmonary artery

    Science.gov (United States)

    ... of the left coronary artery arising from the pulmonary artery; ALCAPA; ALCAPA syndrome; Bland-White-Garland syndrome; ... children with ALCAPA, the LCA originates from the pulmonary artery. The pulmonary artery is the major blood ...

  7. Carotid and vertebral artery dissections: examination strategies in MR imaging and MR angiography; Kraniozervikale Dissektionen: Untersuchungsstrategien in der MR-Tomographie und MR-Angiographie

    Energy Technology Data Exchange (ETDEWEB)

    Keller, E.; Flacke, S.; Sommer, T.; Brechtelsbauer, D.; Pauleit, D.; Textor, J.; Schild, H.H. [Radiologische Universitaetsklinik Bonn (Germany); Gieseke, J. [Philips Medizin Systeme, Bonn (Germany); Gass, S. [Neurologische Universitaetsklinik Bonn (Germany)

    1997-12-01

    Purpose: To define the diagnostic efficacy of MR imaging, `time of flight` (TOF) and phase contrast (PC) MR angiography in craniocervical arterial dissections. Material and methods: The MR examinations of 16 patients with proven arterial dissections (n=20) were retrospectively analysed by three independent readers. The MR protocol included T{sub 1}w spin echo sequences with and without fat saturation (SPIR), T{sub 2}w-turbo-spin echo, 2D- and 3D-TOF- and 3D-PC-MRA. The study was undertaken to assess the diagnostic sensitivity of each technique in detecting typical pathological features. Results: The overall sensitivity was best in 3D-PC-MRA; reaching 88% of all possible points. Intramural haematoma could be easily detected with T{sub 1}w spin echo with fat saturation (100%). Intimal flap and lumen narrowing was best defined with 3D-TOF-MRA in 86% resp. 96% and 3D-PC-MRA in 69% resp. 97%. 3D-PC-MRA was superior to all other sequences in 5 cases of aneurysmal dissection (100%). Conclusions: An accurate evaluation of craniocervical arterial dissections should rely on a combined protocol including T{sub 1}w spin echo with fat saturation and an axial 3D-MR angiography (if possible 3D-phase contrast MRA). (orig.) [Deutsch] Ziel: Die Studie untersucht die Aussagekraft der MR-Tomographie, der `time of flight` (TOF)- und der Phasenkontrast (PC)-MR-Angiographie bei kraniozervikalen Dissektionen. Material und Methoden: Retrospektiv wurden die MR-Untersuchungen von 16 Patienten mit 20 gesicherten Dissektionen ausgewertet. Das Untersuchungsprotokoll umfasste axiale T{sub 1}-gew. Spin-Echo-Sequenzen mit und ohne frequenzselektive Fettunterdrueckung (SPIR), T{sub 2}-gewichtete Turbo-Spin-Echo-Aufnahmen, eine 2D- und 3D-TOF-MRA sowie eine 3D-PC-MRA. Die einzelnen Verfahren wurden hinsichtlich der Diagnosestellung und der Erfassung typischer pathologischer Befunde durch drei unabhaengige Untersucher ausgewertet. Ergebnisse: Das beste Gesamtergebnis fuer alle Bewertungskriterien

  8. Evolutionary and Developmental Origins of the Cardiac Neural Crest: Building a Divided Outflow Tract

    Science.gov (United States)

    Keyte, Anna L.; Alonzo-Johnsen, Martha; Hutson, Mary R.

    2015-01-01

    The cardiac neural crest cells (CNCCs) have played an important role in the evolution and development of the vertebrate cardiovascular system: from reinforcement of the developing aortic arch arteries early in vertebrate evolution, to later orchestration of aortic arch artery remodeling into the great arteries of the heart, and finally outflow tract septation in amniotes. A critical element necessary for the evolutionary advent of outflow tract septation was the co-evolution of the cardiac neural crest cells with the second heart field. This review highlights the major transitions in vertebrate circulatory evolution, explores the evolutionary developmental origins of the CNCCs from the third stream cranial neural crest, and explores candidate signaling pathways in CNCC and outflow tract evolution drawn from our knowledge of DiGeorge Syndrome. PMID:25227322

  9. Lamprey: a model for vertebrate evolutionary research

    Science.gov (United States)

    XU, Yang; ZHU, Si-Wei; LI, Qing-Wei

    2016-01-01

    Lampreys belong to the superclass Cyclostomata and represent the most ancient group of vertebrates. Existing for over 360 million years, they are known as living fossils due to their many evolutionally conserved features. They are not only a keystone species for studying the origin and evolution of vertebrates, but also one of the best models for researching vertebrate embryonic development and organ differentiation. From the perspective of genetic information, the lamprey genome remains primitive compared with that of other higher vertebrates, and possesses abundant functional genes. Through scientific and technological progress, scientists have conducted in-depth studies on the nervous, endocrine, and immune systems of lampreys. Such research has significance for understanding and revealing the origin and evolution of vertebrates, and could contribute to a greater understanding of human diseases and treatments. This review presents the current progress and significance of lamprey research. PMID:27686784

  10. Global analysis of human duplicated genes reveals the relative importance of whole-genome duplicates originated in the early vertebrate evolution.

    Science.gov (United States)

    Acharya, Debarun; Ghosh, Tapash C

    2016-01-22

    Gene duplication is a genetic mutation that creates functionally redundant gene copies that are initially relieved from selective pressures and may adapt themselves to new functions with time. The levels of gene duplication may vary from small-scale duplication (SSD) to whole genome duplication (WGD). Studies with yeast revealed ample differences between these duplicates: Yeast WGD pairs were functionally more similar, less divergent in subcellular localization and contained a lesser proportion of essential genes. In this study, we explored the differences in evolutionary genomic properties of human SSD and WGD genes, with the identifiable human duplicates coming from the two rounds of whole genome duplication occurred early in vertebrate evolution. We observed that these two groups of duplicates were also dissimilar in terms of their evolutionary and genomic properties. But interestingly, this is not like the same observed in yeast. The human WGDs were found to be functionally less similar, diverge more in subcellular level and contain a higher proportion of essential genes than the SSDs, all of which are opposite from yeast. Additionally, we explored that human WGDs were more divergent in their gene expression profile, have higher multifunctionality and are more often associated with disease, and are evolutionarily more conserved than human SSDs. Our study suggests that human WGD duplicates are more divergent and entails the adaptation of WGDs to novel and important functions that consequently lead to their evolutionary conservation in the course of evolution.

  11. Anomalous origin of left coronary artery arising from the right coronary cusp presenting with chest discomfort and syncope on physical exercise

    Directory of Open Access Journals (Sweden)

    Ran Baik

    2010-02-01

    Full Text Available Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG, and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE and heart computed tomography (CT. She underwent a corrective operation by re-implantation, CABG, and unroofing.

  12. Reconstructing the ancestral vertebrate brain.

    Science.gov (United States)

    Sugahara, Fumiaki; Murakami, Yasunori; Pascual-Anaya, Juan; Kuratani, Shigeru

    2017-05-01

    Highly complicated morphologies and sophisticated functions of vertebrate brains have been established through evolution. However, the origin and early evolutionary history of the brain remain elusive, owing to lack of information regarding the brain architecture of extant and fossil species of jawless vertebrates (agnathans). Comparative analyses of the brain of less studied cyclostomes (only extant agnathan group, consisting of lampreys and hagfish) with the well-known sister group of jawed vertebrates (gnathostomes) are the only tools we have available to illustrate the ancestral architecture of the vertebrate brain. Previous developmental studies had shown that the lamprey lacked well-established brain compartments that are present in gnathostomes, such as the medial ganglionic eminence and the rhombic lip. The most accepted scenario suggested that cyclostomes had fewer compartments than that of the gnathostome brain and that gnathostomes thus evolved by a stepwise addition of innovations on its developmental sequence. However, recent studies have revealed that these compartments are present in hagfish embryos, indicating that these brain regions have been acquired before the split of cyclostomes and gnathostomes. By comparing two cyclostome lineages and gnathostomes, it has become possible to speculate about a more complex ancestral state of the brain, excluding derived traits in either of the lineages. In this review, we summarize recent studies on the brain development of the lamprey and hagfish. Then, we attempt to reconstruct the possible brain architecture of the last common ancestor of vertebrates. Finally, we discuss how the developmental plan of the vertebrate brain has been modified independently in different vertebrate lineages. © 2017 Japanese Society of Developmental Biologists.

  13. COMPARATIVE EVALUATION OF EFFICACY AND TOLERABILITY OF ORIGINAL AND GENERIC BISOPROLOL IN PATIENTS WITH ARTERIAL HYPERTENSION 1-2 GRADE

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    S. N. Tolpygina

    2007-01-01

    Full Text Available Aim. To study a clinical equivalence of two medications of bisoprolol in patients with arterial hypertension (AH 1-2 grades.Methods. Efficacy and tolerability of original (Concor, NYCOMED, Merck KGaA and generic (Bisogamma, WORWAG PHARMA GmbH & Co bisoprolol were investigated in open-label cross-over randomized comparative study. 32 patients (15 males and 17 females with AH of 1 (66% and 2 (34% grades aged of 60 y.o. on average were involved. After 2 weeks of wash-out period original or generic bisoprolol 5 mg daily was prescribed. If necessary a dose of drug was doubled in two weeks. In patients with significant bradycardia (heart rate <55 bp/min or atrioventricular block (1-2 degree hydrochlorothiazide (HCT 12.5-25 mg per day was added. There was another 2-week wash-out period between two active treatment periods.Results. Systolic and diastolic blood pressure (SBP, DBP as well as heart rate (HR were decreased significantly after two weeks of treatment with original bisoprolol (∆SBP=13.8±8.9, ∆DBP=8.5±8.6 mmHg and ∆HR=9.9±13.7 bp/min. Generic medication also significantly reduced SBP, DBP and HR (∆SBP=10.1±10.3, ∆DBP=7.1±7.2 mmHg and ∆HR=9.3±9.4 bp/min. Target SBP/DBP levels were achieved in 62.5%/71.9% of patients in Concor group and in 43.7%/62.5% of patients in Bisogamma group. There was a tendency to additional SBP decrease in patients treated with bisoprolol at a dose of 10 mg and with HCT in Concor group (–5.1±7.4 mmHg; p<0.09 and in Bisogamma group (–5.2±7.9 mmHg; p<0.06. After 4 weeks of treatment target SBP/DBP levels were achieved in 90.1%/96.9% of patients in Concor group and 75%/84.4% patients in Bisogamma group. The investigated parameters did not change significantly in a period between the 4 and 6 weeks of treatment. Monotherapy with Concor and Bisogamma was effective in 84.4% in 62% of patients, respectively (p<0.05. After 6 weeks of treatment target SBP and DBP levels were achieved in 96.9% of patients

  14. Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yi; Cheng, Cheng; Wang, Lu; Li, Ran; Chen, Jin-hua; Gong, Shui-gen [Institute of Surgery Research, Daping Hospital, Third Military Medical University, Department of Radiology, Chongqing (China)

    2014-08-15

    To identify the spectrum and prevalence of anatomical variations in the origin of the celiac axis (CA), the superior mesenteric artery (SMA) and their major branches by using multidetector computed tomographic (MDCT) angiography. A retrospective evaluation was carried out on 1,500 abdominal MDCT angiography images. The aortic origins of the CA, the SMA and their major branch patterns were investigated. Normal aortic origins of CA and SMA were noted in 1,347 (89.8 %) patients. Seven types of CA and SMA origin variants were identified in 153 (10.2 %) patients. The three most common variations were hepatomesenteric trunk (67 patients, 4.47 %), celiomesenteric trunk (CMT) (51 patients, 3.4 %) and splenomesenteric trunk (18 patients, 1.2 %). An evaluation of CMT was classified as long (34 patients, 66.7 %) or short (17 patients, 33.3 %) subtypes, compared with the length of the common trunk. Further CMT classification was based on the origin of the left gastric artery: subtype I, 26 patients (53.1 %); subtype II, 5 patients (10.2 %); subtype III, 15 patients (30.6 %); subtype IV, 3 patients (6.1 %). Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could be the embryological mechanisms of the variant origins of the CA, the SMA and their major branches. (orig.)

  15. CLINICAL AND PHARMACOKINETIC EQUIVALENCE OF ORIGINAL AND GENERIC AMLODIPINE IN PATIENTS WITH MILD-TO-MODERATE ARTERIAL HYPERTENSION

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    N. A. Belolipetskiy

    2007-01-01

    Full Text Available Aim. To study clinical equivalence of two amlodipines under the control of their plasma levels and evaluate their pharmacoeconomical efficacy in patients with arterial hypertension (AH.Material and methods. 31 patient with AH were included in the study (14 men and 17 women. 21 (66 % patients had AH of 1 stage and 10 (34 % patients had AH of 2 stage. All patients were 39-81 y.o. (average - 60 y.o. with AH duration 0,5-43 years (average - 17,9 years. Antihypertensive effect of Amlorus (Synthesis, Russia and Norvasc (Pfizer, USA was evaluated in the study. Blood pressure (BP, amlodipine plasma levels (by liquid chromatography with mass spectrometry and side effects were registered before and after 2, 4 and 6 weeks of therapy. Hydrochlorothiazide 25 mg/d was added if the monotherapy with amlodipine10 mg/d had not been efficient. Therapy with the second studied amlodipine followed the therapy with the first drug.Results. Both drugs provided similar plasma amlodipine concentrations with significant BP reduction. 96,6 % and 90 % of patients reached BP target level (<140/90 mm Hg after 6 weeks of Amlorus and Norvasc therapy, respectively. Hydrochlorothiazide was needed in 23,3 % and 26,7 % of patients taking Amlorus and Norvasc, respectively. Cost of Amlorus therapy per patient was 221 rbl/month in comparison with cost of 727 rbl/month for Norvasc therapy.Conclusion. Generic Amlorus showed clinical and pharmacokinetic equivalency with an original amlodipine Norvasc and lower cost of therapy.

  16. Basilar artery occlusion following yoga exercise: a case report.

    Science.gov (United States)

    Fong, K Y; Cheung, R T; Yu, Y L; Lai, C W; Chang, C M

    1993-01-01

    Basilar artery occlusion developed in a 34 year old woman 2 months after adopting unusual neck postures during yoga practice. On angiography, her basilar artery was filled with intraluminal clot while the vertebral arteries were normal. We postulate that a severe reduction in blood flow and possibly an intimal tear triggered thrombosis of the vertebral artery and that the final stroke mechanism was artery-to-artery embolism.

  17. Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes Spontaneous cervical carotid and vertebral arteries dissection: study of 48 patients

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    Cynthia Resende Campos

    2004-06-01

    Full Text Available OBJETIVO: Dada a ausência de estudos de séries brasileiras de pacientes com dissecção arterial cervical espontânea, com o objetivo de descrever os fatores de risco, sintomas precedentes, manifestações clínicas, resultados da investigação, tratamento e evolução. MÉTODO: realizamos a análise retrospectiva dos prontuários e laudos radiológicos [angiografia digital(AD, ressonância magnética(RM e ângio-ressonância(ARM] dos pacientes com esse diagnóstico atendidos no Serviço de Neurologia do HC/USP entre 1997 e 2003. RESULTADOS: 48 pacientes (24 homens, média de idade 37,9 anos; 26 pacientes com dissecção carotídea (DC unilateral, 15 com vertebral (DV unilateral e 7 com multiarterial, todos com déficits neurológicos. Os principais fatores de risco para doença vascular foram hipertensão arterial, tabagismo e dislipidemia. Mais de 80% apresentaram pelo menos um sintoma precedente, na maioria cefaléia têmporo-parietal. Cervicalgia foi referida por 44% dos pacientes com DV e por 3,4% dos com DC. O tempo médio entre o primeiro sintoma e o déficit foi 5,4 dias para as DC e 13,5 para as DV. AD foi o principal método diagnóstico (93%, associado a RM e ARM em 42% dos casos. Em 3 pacientes a RM cervical com supressão de gordura foi isoladamente suficiente. 75% dos pacientes receberam anticoagulação. Dois pacientes fizeram trombólise endovenosa sem complicações. A evolução foi boa, exceto por dois óbitos (DC bilateral. CONCLUSÃO: Os resultados são semelhantes aos da literatura, exceto pela baixa freqüência de cervicalgia nos casos de DC e pelo predomínio de cefaléia têmporo-parietal nas dissecções arteriais cervicais. Fatores de risco para doença vascular isquêmica foram frequentes.OBJETIVE: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD: We performed the retrospective

  18. Anomalous Origin of the Right Pulmonary Artery From the Ascending Aorta in a 10-Month-Old Child: A Case Report From Tanzania.

    Science.gov (United States)

    Pallangyo, Pedro; Lyimo, Frederick; Nicholaus, Paulina; Mtolera, Maria

    2016-01-01

    Anomalous origin of the right pulmonary artery from the ascending aorta is a rare congenital deformity associated with poor quality of life and reduced life expectancy. Without a corrective surgery, less than one third of cases will live to see their sixth month. We report a case of a 10-month-old male child from Tanzania who presented with a 6-month history of recurrent respiratory tract infections, mild effort intolerance, and failure to thrive.

  19. Efeitos da simpaticotomia endoscópica sobre as artérias carótidas e vertebrais na terapêutica cirúrgica da hiperidrose primária Effects of endoscopic sympathicotomy in carotid and vertebral arteries in the surgical treatment of primary hiperhidrosis

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    Jeancarlo F. Cavalcante

    2005-01-01

    Full Text Available OBJETIVOS: Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP, as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia, através da mensuração de parâmetros ultra-sonográficos. MÉTODO: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS, velocidade de pico diastólico (VPD, índice de pulsatibilidade (IP e índice de resistência (IR nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. RESULTADOS: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%, seja isoladamente (25% ou associada a T4 (62,50% ou a T2 (8,33%. Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (pPURPOSES: Analyze, in patients with primary hyperhidrosis (PH who was undergone to videothoracoscopic sympathicotomy, the degree of vascular denervation after surgical transection of the thoracic sympathetic chain by measuring ultrasonografic parameters in carotid and vertebral arteries. METHODS: Twenty-four patients with PH underwent forty-eight endoscopic thoracic sympathicotomy and were evaluated by duplex eco-doppler measuring systolic peak velocity (SPV, diastolic peak velocity (DPV, pulsatility index (PI and resistivity index (RI in bilateral common, internal and external carotids, besides bilateral vertebral arteries. The exams were performed before operations and a month later. Wilcoxon test was used to

  20. Subclavian artery stenosis caused by non-specific arteritis (Takayasu disease): treatment with Palmaz stent

    Energy Technology Data Exchange (ETDEWEB)

    Maskovic, J.; Jankovic, S.; Lusic, I.; Cambj-Sapunar, L.; Mimica, Z.; Bacic, A

    1999-09-01

    A 32-year old woman was admitted to the hospital with a sudden onset of right-sided hemiplegia and aphasia. Immediate angiographic examination revealed a severe form of type I Takayasu arteritis with occlusion of all supra-aortic vessels, with the exception of the left subclavian artery which was, however, almost completely occluded 1 cm proximal to the origin of the left vertebral artery. Since the latter provided the entire blood supply to the brain tissues, an immediate attempt was undertaken to dilate the left subclavian artery; when this was unrewarding, stenting of the lesion was successfully accomplished with excellent primary and 6-month follow-up results.

  1. Phylogenetic analyses of the hepatic architecture in vertebrates.

    Science.gov (United States)

    Shiojiri, Nobuyoshi; Kametani, Harunobu; Ota, Noriaki; Akai, Yusuke; Fukuchi, Tomokazu; Abo, Tomoka; Tanaka, Sho; Sekiguchi, Junri; Matsubara, Sachie; Kawakami, Hayato

    2018-02-01

    The mammalian liver has a structural and functional unit called the liver lobule, in the periphery of which the portal triad consisting of the portal vein, bile duct and hepatic artery is developed. This type of hepatic architecture is detectable in many other vertebrates, including amphibians and birds, whereas intrahepatic bile ducts run independently of portal vein distribution in actinopterygians such as the salmon and tilapia. It remains to be clarified how the hepatic architectures are phylogenetically developed among vertebrates. The present study morphologically and immunohistochemically analyzed the hepatic structures of various vertebrates, including as many classes and subclasses as possible, with reference to intrahepatic bile duct distribution. The livers of vertebrates belonging to the Agnatha, Chondrichthyes, Amphibia, Aves, Mammalia, and Actinopterygii before Elopomorpha, had the portal triad-type architecture. The Anguilliformes livers developed both periportal bile ducts and non-periportal bile ducts. The Otocephala and Euteleostei livers had independent configuration of bile ducts and portal veins. Pancreatic tissues penetrated the liver parenchyma along portal veins in the Euteleostei. The liver of the lungfish, which shares the same origin with amphibians, did not have the portal triad-type architecture. Teleostei and lungfish livers had ductular development in the liver parenchyma similar to oval cell proliferation in injured mammalian livers. Euteleostei livers had penetration of significant numbers of independent portal veins from their intestines, suggesting that each liver lobe might receive a different blood supply. The hepatic architectures of the portal triad-type changed to non-portal triad-type architecture along the evolution of the Actinopterygii. The hepatic architecture of the lungfish resembles that of the Actinopterygii after Elopomorpha in intrahepatic biliary configuration, which may be an example of convergent evolution.

  2. Origen anómalo de la coronaria izquierda en la arteria pulmonar: una serie de casos Anomalous origin of the left coronary artery: a series of cases

    Directory of Open Access Journals (Sweden)

    Jaiber Gutiérrez

    2009-06-01

    Full Text Available La anomalía de la arteria coronaria izquierda que nace en la arteria pulmonar (ALCAPA por su sigla en Inglés: anomalous left coronary artery from the pulmonary artery, es una enfermedad cardiaca congénita, de baja incidencia y de espectro clínico amplio. La principal forma de presentación es la falla cardiaca por miocardiopatía dilatada. Mediante la revisión de historias clínicas se recolectaron cinco casos consecutivos de ALCAPA, de los que se describen sus cuadros clínicos, así como su diagnóstico y tratamiento. Todos fueron dados de alta en mejores condiciones y asisten a controles periódicos. Estos casos ilustran al origen anómalo de la coronaria izquierda, como diagnóstico diferencial de la miocardiopatía dilatada.Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA is a congenital cardiac anomaly with low incidence and a broad clinical spectrum. Its main form of presentation is congestive heart failure due to dilated cardiomyopathy. We reviewed clinical histories and collected 5 consecutive ALCAPA cases; its clinical symptoms, diagnosis and treatment were described. All five patients were discharged in better clinical conditions and continue attending to periodic medical follow-up. These cases illustrate the ALCAPA as part of the differential diagnosis of dilated cardiomyopathy.

  3. Cerebral Arterial Variations Associated with Moyamoya Disease Diagnosed by MR Angiography.

    Science.gov (United States)

    Uchino, Akira; Saito, Naoko; Takahashi, Masahiro; Kurita, Hiroki; Ishihara, Shoichiro

    2014-12-01

    Moyamoya disease is a rare progressive cerebrovascular steno-occlusive disease associated with different variations of the cerebral arteries. We evaluated the types and prevalence of such variations among patients with moyamoya disease. In our institution during the past seven years, we diagnosed 72 patients (24 male, 48 female; aged 6 to 75 years, mean, 42 years) with moyamoya disease by magnetic resonance (MR) angiography using either a 3-Tesla or one of two 1.5-T imagers and a standard time-of-flight technique without contrast media. An experienced neuroradiologist retrospectively reviewed the images. There were 15 cerebral arterial variations in 13 of 72 patients with moyamoya disease (18.1%), including four basilar artery fenestrations, three ophthalmic arteries arising from the middle meningeal artery, two intracranial vertebral artery fenestrations, two persistent first cervical intersegmental arteries, two persistent trigeminal arteries, one extracranial origin of the posterior inferior cerebellar artery, and one persistent stapedial artery. Although our number of patients was small, moyamoya disease was frequently associated with variations of the cerebral arteries, especially fenestrations in the vertebrobasilar system and persistent trigeminal artery.

  4. Radial Artery Aneurysm

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    Ali Fedakar

    2011-04-01

    Full Text Available Upper limb aneurysms are less frequently seen than the other aneurysm. Radial arterial aneurysm is usually associated with the trauma. Interventional procedures can cause pseudoaneurysm at the radial artery puncture sites. Radial artery aneurysm may cause the thromboembolic events at the fingers and the hand. We present a case of isolated radial arterial aneurysm with idiopathic origin.

  5. Quality of life and exercise performance in unoperated children with anomalous aortic origin of a coronary artery from the opposite sinus of valsalva.

    Science.gov (United States)

    Sing, Alan C; Tsaur, Stephen; Paridon, Stephen M; Brothers, Julie A

    2017-07-01

    Anomalous aortic origin of a coronary artery is a congenital cardiac condition that can be associated with increased risk of sudden death. To date, quality of life and exercise performance have not been evaluated in patients with this condition who do not undergo surgical repair. We carried out a cross-sectional analysis of patients with unoperated anomalous aortic origin of a coronary artery at our institution from 1 January, 2000 to 31 January, 2016. We prospectively assessed quality of life using standardised questionnaires. Medical records were reviewed for clinical and exercise stress test data. Statistical analyses were performed using Student's t-tests and Spearman's correlation coefficients. In total, 56 families completed the questionnaires. The average age at enrolment was 14.7±6 years. The majority were male (n=44, 78.6%) and had interarterial anomalous right coronary artery (n=38, 67.9%). Patients had normal quality of life on the PedsQL 4.0 Report, Child Health Questionnaire Child Form 87, and SF-36v2. Their parents had normal quality of life on the PedsQL 4.0 Parent Report, but parents of exercise-restricted patients had decreased Physical Functioning, General Health Perception, Emotional Impact on Parent, and Physical Summary scores (porigin of a coronary artery appear to have normal quality of life, but parents of exercise-restricted patients have decreased general health and emotional and physical quality of life scores. Improved counselling of families may be beneficial in this group. Future studies with more patients should evaluate quality of life and exercise performance over time.

  6. Origen anómalo de la arteria coronaria izquierda en la arteria coronaria derecha y curso ínter-arterial Anomalous origin of the left coronary artery arising from the right coronary artery

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    Nilson López

    2010-12-01

    Full Text Available El origen del tronco coronario principal izquierdo a partir de la arteria coronaria derecha o del seno de Valsava opuesto, es una anomalía extremadamente rara con un riesgo potencial de mortalidad. En este informe se describe el caso de una paciente con esta anomalía, inicialmente detectada por coronariografía y posteriormente confirmada mediante resonancia magnética cardiaca.The left main coronary artery arising from the opposite sinus of Valsalva or from the right coronary artery is an extremely rare condition with a potential risk of mortality. This report describes the case of a female patient with this coronary artery anomaly, initially detected by coronariography and subsequently confirmed by cardiac magnetic resonance.

  7. Anomalous origin of the right pulmonary artery from the ascending aorta associated with patent ductus arteriosus: focusing on computed tomography findings.

    Science.gov (United States)

    Kim, Minchul; Woo, Jeong Joo; An, Jin Kyung; Cho, Young Kwon

    2015-03-01

    Anomalous origin of one pulmonary artery from the ascending aorta (AOPA) is a rare congenital malformation. Fewer than 150 cases have been reported to date in the world, with 95 % of these documented during the first year of the patient's life. We encountered a rare case of AOPA associated with patent ductus arteriosus in a 41-year-old female, who had reached the most advanced age of any known, previously untreated AOPA patient. We herein present our findings for this patient on plain chest radiography, computed tomography, and perfusion scan.

  8. [Prosthesis interposition in the case of subclavian artery transposition].

    Science.gov (United States)

    György, G; Acosta Alvarez, P

    1993-01-01

    When we can't realize the reimplantation because of technical difficulties, special cases are presented during transposition from the subclavian artery to the primitive carotid artery. In these cases, between primitive carotid artery and the subclavian artery and also the vertebral artery, Gore-tex's tubes were implanted with favourable results.

  9. BILATERAL DUPLICATION OF RENAL ARTERIES

    OpenAIRE

    Prajkta A Thete; Mehera Bhoir; M.V.Ambiye

    2014-01-01

    Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, su...

  10. Potential underdiagnosis of osteoporosis in repeated vertebral augmentation for new vertebral compression fractures

    Directory of Open Access Journals (Sweden)

    İlhan B

    2015-09-01

    Full Text Available Birkan İlhan, Fatih Tufan, Gülistan Bahat, Mehmet Akif KaranDivision of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, TurkeyWe read with great interest the article by Liang et al “Repeated vertebral augmentation for new vertebral compression fractures of postvertebral augmentation patients: a nationwide cohort study”.1\tIn their study, the authors investigated the factors possibly associated with new vertebral compression fractures in patients who previously had vertebral augmentation procedures. They reported that osteoporosis (OP was not observed as a risk factor for repeat vertebral augmentation. Among multiple chronic diseases, hypertension (HT was reported as one factor associated with new vertebral fractures. Among the medications used to treat or prevent OP, they reported calcium/vitamin D, bisphosphonates, and calcitonin were associated with not having repeat vertebral augmentation. However, steroids, paracetamol, and nonsteroidal anti-inflammatory drugs were associated with having repeat vertebral augmentation. We would like to comment on their article.View original paper by Kurimato and colleagues.

  11. COMPARISON OF PHARMACOKINETICS AND PHARMACODYNAMICS OF THE ORIGINAL AND GENERIC ENALAPRIL IN THE ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    O. P. Bobrova

    2012-01-01

    Full Text Available Aim. To study the pharmacokinetic, pharmacodynamic and pharmacoeconomic parameters of the original and generic enalaprils in the treatment of the elderly patients with hypertension (HT. Material and Methods. Patients (n=40 75–90 years with HT were included in the open randomized comparative study. Patients were randomized into two groups. Patients of the group 1 received generic enalapril, patients of the group 2 — the original enalapril consisting of combined therapy. Pharmacokinetic single-dose study of original and generic enalapril were carried out with high-performance liquid chromatography. Pharmacodynamic study was carried out in single-dose administration as well as after 2 and 4 weeks of treatment with original and generic enalapril. Pharmacoeconomic evaluation of antihypertensive drugs was carried out on the basis of cost minimization analysis. Results. Original enalapril dose necessary to achieve the target blood pressure (BP was 10 mg/day as a part of two-component therapy. This for generic enalapril was 20 mg/day consisting of three- or four-component therapy. Both drugs have shown an acceptable safety profile. Pharmacokinetic differences were revealed between original and generic enalapril: area under pharmacokinetic curve 204.14 (202.25–206.05 vs 136.23 (134.17–137.65 ng*h/ml, respectively; time of the drug retention in the blood plasma 5.42 (5.26–5.76 vs 4.88 (4.86–4.94 hours, respectively; p<0.001. Original enalapril demonstrated more stable 24-hour antihypertensive effect in once daily administration in comparison with this in generic enalapril: trough/peak ratio 78.67% (47.61–91.35% vs 44.96% (32.44–55.49%, respectively , p<0.01. The average daily cost of combined therapy containing generic enalapril was 15.91 rubles per patient, while this in combined therapy containing original enalapril — 13.78 rubles per patient. Conclusion. Medicines on the basis of original and generic enalapril have pharmacokinetic

  12. The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Song, Dawei; Meng, Bin; Gan, Minfeng; Niu, Junjie; Li, Shiyan; Chen, Hao; Yuan, Chenxi; Yang, Huilin

    2015-08-01

    Percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) are minimally invasive and effective vertebral augmentation techniques for managing osteoporotic vertebral compression fractures (OVCFs). Recent meta-analyses have compared the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques or conservative treatment; however, the inclusions were not thorough and rigorous enough, and the effects of each technique on the incidence of secondary vertebral fractures remain unclear. To perform an updated systematic review and meta-analysis of the studies with more rigorous inclusion criteria on the effects of vertebral augmentation techniques and conservative treatment for OVCF on the incidence of secondary vertebral fractures. PubMed, MEDLINE, EMBASE, SpringerLink, Web of Science, and the Cochrane Library database were searched for relevant original articles comparing the incidence of secondary vertebral fractures between vertebral augmentation techniques and conservative treatment for patients with OVCFs. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (NRCTs) were identified. The methodological qualities of the studies were evaluated, relevant data were extracted and recorded, and an appropriate meta-analysis was conducted. A total of 13 articles were included. The pooled results from included studies showed no statistically significant differences in the incidence of secondary vertebral fractures between patients treated with vertebral augmentation techniques and conservative treatment. Subgroup analysis comparing different study designs, durations of symptoms, follow-up times, races of patients, and techniques were conducted, and no significant differences in the incidence of secondary fractures were identified (P > 0.05). No obvious publication bias was detected by either Begg's test (P = 0.360 > 0.05) or Egger's test (P = 0.373 > 0.05). Despite current thinking in the

  13. [Angioplasty of the anterior descending artery with abnormal origin: use of a new low-profile catheter balloon. A case report].

    Science.gov (United States)

    Tanajura, L F; Maldonado, G; Cano, M N; Mattos, L A; Feres, F; Pinto, I M; Fontes, V F; Souza, A G; Sousa, J E

    1990-03-01

    It is possible to perform transluminal coronary angioplasty (TCA) in thin vessels presenting severe obstructions. One of the achievements that made such procedure possible is the development of a new generation of balloon catheters. In this case report the TCA was performed in a very thin left anterior descending artery with an anomalous origin, a quite rare situation that represents a major problem to the traditional dilator system. The catheter used was a Probe (USCI), which differs of the traditional balloons in a number of characteristics. The authors consider the procedure in detail pointing out the advantages of using of the new generations and discuss the impact that newer technological developments will have in enlarging the indications for TCA and improving the results.

  14. Use of the frozen elephant trunk technique in complicated chronic dissection with porcelain aorta and visceral arteries originating from different lumens.

    Science.gov (United States)

    Zembala, Michal O; Irimie, Vadim; Urbanski, Paul P

    2016-04-01

    A rare case of aortic arch aneurysm combined with chronic aortic dissection is reported. Because the visceral arteries originated from different, equivalently perfused lumens and the descending aorta was circumferentially calcified (porcelain aorta) limiting the possibilities of anastomosing, careful planning of the surgical strategy was of utmost importance. The complex surgery consisted of ascending and total arch replacement using the 'frozen elephant trunk' technique with Thoraflex™ Hybrid Prosthesis (Vascutek, Terumo, Inchinnan, Scotland); however, before insertion of the stent graft, an angioscopic resection of the dissection membrane in the proximal part of the descending aorta was carried out to ensure a complete expansion of the distal edge of the stent within the entire common lumen of the aorta and unimpaired distal flow in both lumens below the stent graft. The surgery and the postoperative course were uneventful. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. A cadaveric study of the anatomical variation of the origins of the celiac trunk and the superior mesenteric artery: a role in median arcuate ligament syndrome?

    Science.gov (United States)

    Katz-Summercorn, Annalise; Bridger, John

    2013-11-01

    Gray's Anatomy states, "the celiac trunk is the first anterior branch of the abdominal aorta and arises just below the aortic hiatus. The superior mesenteric artery originates from the aorta c1.0 cm below the celiac trunk." (Standring, 2008a, Gray's Anatomy. 40th Ed. London: Churchill Livingstone Elsevier, p. 1073-1074). During dissection classes with medical students we found this not to be the case. We have re-evaluated the anatomy of the origins of the celiac trunk (CT) and superior mesenteric artery (SMA) and the relationship of the CT to the median arcuate ligament (MAL) in 99 cadavers. We have found the external distance between the CT and SMA to range from 0 to 20 mm (mean 3.4 mm, SD 5.17 mm), with the two in direct apposition in 57.6% (n = 99) of cases: a higher figure than previously documented. However, the internal distance between the CT and SMA ranged from 10 to 30 mm (mean 18.9 mm, SD 4.09 mm). There was no distance measurable between the MAL and the CT in 88 cadavers (92.6%, n = 95) and, of these, 32 (33.7%) showed evidence of compression or kinking of the CT. We suspect that the MAL is responsible for the approximation of the CT to the SMA in these cadavers, and that the high incidence of kinking of the CT (33.7% of cases) may have implications with regard to its role in MAL syndrome. Copyright © 2013 Wiley Periodicals, Inc.

  16. Vertebral osteomyelitis without disc involvement

    Energy Technology Data Exchange (ETDEWEB)

    Kamani, I.; Syed, I.; Saifuddin, A. E-mail: asaifuddin@aol.com; Green, R.; MacSweeney, F

    2004-10-01

    Vertebral osteomyelitis is most commonly due to pyogenic or granulomatous infection and typically results in the combined involvement of the intervertebral disc and adjacent vertebral bodies. Non-infective causes include the related conditions of chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. Occasionally, these conditions may present purely within the vertebral body, resulting in various combinations of vertebral marrow oedema and sclerosis, destructive lesions of the vertebral body and pathological vertebral collapse, thus mimicking neoplastic disease. This review illustrates the imaging features of vertebral osteomyelitis without disc involvement, with emphasis on magnetic resonance imaging (MRI) findings.

  17. Anomalous origin of the left coronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman.

    Science.gov (United States)

    Yau, James M; Singh, Rajiv; Halpern, Ethan J; Fischman, David

    2011-04-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Current management is based on limited case series or extrapolated from pediatric cases. Modern advances in noninvasive cardiac imaging have substantially increased the number of diagnoses, uncovering a large adult population that has not been reviewed. The availability of newer diagnostic modalities correlates with an increasing incidence in an older cohort, and true association between sudden death and ALCAPA may be lower, especially among older patients. A comprehensive literature search was performed for all case reports of ALCAPA on MEDLINE and PubMed using the keywords ALCAPA, Bland-White-Garland, and coronary anomaly; and augmented by references from published case reports from 1908 to 2008. All adult cases, defined by age 18 years and older, were reviewed for this article. One hundred fifty-one adult cases of ALCAPA are described, in addition to the case of an asymptomatic 53-year-old woman. The average reported age was 41 years old with the oldest being 83. Sixty-six percent of the patients presented with symptoms of angina, dyspnea, palpitations, or fatigue; 17% presented with ventricular arrhythmia, syncope, or sudden death; and 14% were asymptomatic. Twelve percent were diagnosed at autopsy. The majority had some form of surgical correction during their clinical course. ALCAPA is a rare and life-threatening condition in adults. The availability of newer, less invasive diagnostic modalities has resulted in more frequent identification of this condition in an older cohort. © 2011 Wiley Periodicals, Inc.

  18. A rare case of Cystic artery arising from Gastroduodenal artery ...

    African Journals Online (AJOL)

    An uncommon anatomical variation in the origin and course of cystic artery was found during human cadaveric dissection in our laboratory. A blood vessel was seen arising from the gastroduodenal artery about 1 cm distal to its origin from the common hepatic artery. The vessel when traced towards its termination was found ...

  19. Vertebral Fracture Prediction

    DEFF Research Database (Denmark)

    2008-01-01

    Vertebral Fracture Prediction A method of processing data derived from an image of at least part of a spine is provided for estimating the risk of a future fracture in vertebraeof the spine. Position data relating to at least four neighbouring vertebrae of the spine is processed. The curvature...

  20. Routine needle biopsy during vertebral augmentation procedures. Is it necessary?

    Science.gov (United States)

    Pneumaticos, Spiros G; Chatziioannou, Sofia N; Savvidou, Christiana; Pilichou, Anastasia; Rontogianni, Dimitra; Korres, Dimitrios S

    2010-11-01

    Vertebral augmentation procedures are currently widely performed to treat vertebral compression fractures. The purpose of this study was to determine the frequency of underlying previously unrecognized etiology in a consecutive series of patients undergoing kyphoplasty to treat vertebral compression fractures. A prospective histological evaluation of vertebral body biopsy specimens from presumed osteoporotic vertebral compression fractures were performed in order to identify aforementioned causes. Over a 2-year period, vertebral body biopsies from 154 vertebral levels were performed in 75 patients undergoing kyphoplasty for vertebral compression fractures. All patients received a preoperative workup that included plain radiographs, MRI, whole body bone scan, and laboratory examinations. Bone specimens were obtained from affected vertebral bodies and submitted for histologic evaluation to identify the prevalence of an underlying cause. All specimens demonstrated fragmented bone with variable amounts of unmineralised bone, signs of bone-remodeling and/or fracture-healing. In 11 patients underlying pathology other than osteoporosis was identified (prostate cancer, 1; pancreatic cancer, 1; colon cancer, 1; breast cancer, 2; multiple myeloma, 3; leukemia, 1; and lung cancer, 2). In all but one patient the results of the biopsy confirmed the diagnosis suspected from the preoperative workup. For the last patient, namely the one with pancreatic cancer, the workup did not identify the origin of the primary tumor, although the patient was considered to have a compression fracture secondary to metastatic disease of unknown origin, the vertebral biopsy suggested the presence of adenocarcinoma which eventually was proven to be pancreatic cancer. In augmentation procedures for vertebral compression fractures, bone biopsy should be reserved for the patients where the preoperative evaluation raises the suspicion of a non-osteoporotic etiology.

  1. Aberrant Right Subclavian Artery: A Life‑threatening Anomaly that ...

    African Journals Online (AJOL)

    Lusoria artery or aberrant right subclavian artery (ARSA) is a rare anatomical variation of the origin of the right subclavian artery. Essentially, right subclavian artery originates from the brachiocephalic artery, but in 0.4-1.8% of the general population it may arise directly from the aortic arch distal to the left subclavian artery.

  2. Evolution of the vertebrate claudin gene family: insights from a basal vertebrate, the sea lamprey.

    Science.gov (United States)

    Mukendi, Christian; Dean, Nicholas; Lala, Rushil; Smith, Jeramiah; Bronner, Marianne E; Nikitina, Natalya V

    2016-01-01

    Claudins are major constituents of tight junctions, contributing both to their intercellular sealing and selective permeability properties. While claudins and claudin-like molecules are present in some invertebrates, the association of claudins with tight junctions has been conclusively documented only in vertebrates. Here we report the sequencing, phylogenetic analysis and comprehensive spatiotemporal expression analysis of the entire claudin gene family in the basal extant vertebrate, the sea lamprey. Our results demonstrate that clear orthologues to about half of all mammalian claudins are present in the lamprey, suggesting that at least one round of whole genome duplication contributed to the diversification of this gene family. Expression analysis revealed that claudins are expressed in discrete and specific domains, many of which represent vertebrate-specific innovations, such as in cranial ectodermal placodes and the neural crest; whereas others represent structures characteristic of chordates, e.g. pronephros, notochord, somites, endostyle and pharyngeal arches. By comparing the embryonic expression of claudins in the lamprey to that of other vertebrates, we found that ancestral expression patterns were often preserved in higher vertebrates. Morpholino mediated loss of Cldn3b demonstrated a functional role for this protein in placode and pharyngeal arch morphogenesis. Taken together, our data provide novel insights into the origins and evolution of the claudin gene family and the significance of claudin proteins in the evolution of vertebrates.

  3. High origin of the deep femoral artery: a case report and literature review Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Vishal Kumar

    2011-09-01

    Full Text Available Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery arose directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretamente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida.

  4. COMPARISON OF ANTIPLATELET EFFECT AND SAFETY OF ORIGINAL DRUG «ASPIRIN CARDIO» AND GENERIC«ACECARDOL» IN PATIENTS WITH ARTERIAL HYPERTENSION 1-2 GRADE

    Directory of Open Access Journals (Sweden)

    N. A. Belolipetskiy

    2008-01-01

    Full Text Available Aim. To compare antiplatelet effect of two acetylsalicylic acid medicines, Acecardol ("Synthesis Co. Ltd", Russia and Aspirin cardio («Bayer AG», Germany, in patients with arterial hypertension (AH 1-2 stage with increased risk of cardiovascular events.Material and methods. The study was double-blind, randomized, cross-over one. 32 hypertensive patients (12 men and 20 women aged 59,4±14,4 y.o. were included in the study. They took investigated ASA medicines one after another during 4 weeks each. Antiplatelet efficacy of ASA medicines were estimated by effects on spontaneous and ADP-induced platelet aggregation at every visit.Results. 4-week therapy with both ASA medicines did not have significant effects on spontaneous platelet aggregation and the aggregation induced with low ADP concentrations (0,5 and 1,0 µM. However platelet aggregation induced with ADP in concentration of 2 µM was significantly reduced by therapies. There were not significant inter-group differences.Conclusion. ASA generic medicine Acecardol ("Synthesis Co.Ltd.", Russia and original medicine Aspirin cardio («Bayer AG», Germany are equivalent on antiplatelet effect.

  5. Predicting vertebral bone strength by vertebral static histomorphometry

    DEFF Research Database (Denmark)

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

    2002-01-01

    The study investigates the relationship between static histomorphometry and bone strength of human lumbar vertebral bone. The ability of vertebral histomorphometry to predict vertebral bone strength was compared with that of vertebral densitometry, and also with histomorphometry and bone strength...... of the entire vertebral bodies (L-2) were used for histomorphometry. The other iliac crest biopsies and the L-3 were destructively tested by compression. High correlation was found between BV/TV or Tb.Sp and vertebral bone strength (absolute value of r = 0.86 in both cases). Addition of Tb.Th significantly...... of improving the prediction of bone strength of the vertebral body. The correlations between BV/TV of L-2 and bone strength of L-3 were comparable with the correlation obtained by quantitative computed tomography (QCT), peripheral QCT (pQCT), and dual-energy X-ray absorptrometry (DEXA) of L-3 and bone strength...

  6. Sudden onset congestive heart failure with a continuous murmur: ruptured sinus of Valsalva aneurysm complicated by anomalous origin of the left coronary artery.

    Science.gov (United States)

    Seto, Arnold H; Hermer, Alan; Kern, Morton

    2008-01-01

    Ruptured sinus of Valsalva aneurysm is an unusual cause for congestive heart failure, and anomalous coronary arteries have rarely been found in association. A 47-year-old man developed sudden onset heart failure due to a ruptured noncoronary sinus of Valsalva fistula to the right atrium. Coronary angiography revealed an anomalous left coronary artery arising from the right coronary sinus, limiting percutaneous options for repair. We review the incidence, complications, and management of sinus of Valsalva aneurysms and anomalous left coronary arteries.

  7. Sex reversal in vertebrates

    OpenAIRE

    2016-01-01

    This special topic issue of Sexual Development gives an overview of sex reversal in vertebrates, from fishes naturally changing their sex, to rodents escaping the mammalian SRY-determining system. It offers eight up-to-date reviews on specific subjects in sex reversal, considering fishes, amphibians, reptiles, birds, marsupials, and placental mammals, including humans. The broad scope of represented animals makes this ideal for students and researchers, especially those interested in the...

  8. Double renal artery originating from aorta in dog: case report/ Artéria renal dupla originando da aorta em cão: relato de caso

    Directory of Open Access Journals (Sweden)

    Marcelo Abidu-Figueiredo

    2008-08-01

    Full Text Available The presence of the multiple renal artery in dogs, supplying the left kidney, has been reported in 12-15%. New surgery technics in the urogenital tract and the utilization of model for renal transplantation are of clinical significance when considering surgery of that kidney. Courses of anatomy directed veterinary medicine and animal anatomy for students of courses of graduation in the areas of agrarian and biological sciences, use anatomical material proceeding from domestic animals in considerable volume. The use of the material of the laboratories of anatomy for studies of frequency of anatomical variations constitutes way of together contribution to the applied areas, such as the surgery and the clinic. The objective of this report is to presentation of the left multiple renal artery case, originating from the ventral portion of the aorta, in female dog cadaver, with two months, formalin-preserved at 10% and with latex colored vascular injected.A presença de artéria renal múltipla em cães ocorre geralmente do lado esquerdo, em uma freqüência de 12 a 15 %. O avanço de técnicas cirúrgicas no trato urogenital e a utilização de modelos para transplantes renais tornam importante o conhecimento das variações possíveis no que se refere à vascularização dos rins. Cursos de anatomia veterinária e anatomia animal direcionados para estudantes de cursos de graduação nas áreas de ciências agrárias e biológicas, utilizam material anatômico proveniente de animais domésticos em volume considerável. A utilização do acervo dos laboratórios de anatomia para estudos de freqüência de variações anatômicas constitui meio de contribuição junto às áreas aplicadas, tais como a cirurgia e a clínica. O objetivo deste relato é apresentar um caso de artéria renal esquerda dupla, com origem na porção ventral da aorta, em cadáver de cão sem raça definida, com cerca de dois meses de idade, preservado em solução de formol a 10

  9. ORIGINAL ARTICLES

    African Journals Online (AJOL)

    ORIGINAL ARTICLES. Table IlL Type of sharp object, procedure, and mechanism of percutaneous injury among interns. Sharp object (N = 168)*. Hollow needle. Suturing needle. Other. Procedure (N = 177). Phlebotomy. Suturing. Intravenous catheterisation. Arterial puncture. Capillary puncture. Other. Could not recall.

  10. ORIGINAL ARTICLES

    African Journals Online (AJOL)

    2000-08-06

    Aug 6, 2000 ... ORIGINAL ARTICLES. References. 1. Nath H. When does bronchial arterial embolisation fail to control haemoptysis? .... has already recommended the development of DTP-hepatitis B vaccine (HBV) combinations ... clear, particularly in developing countries where the disease occurs in young children, with.

  11. Building the Vertebrate Spine

    Science.gov (United States)

    Pourquié, Olivier

    2008-03-01

    The vertebrate body can be subdivided along the antero-posterior (AP) axis into repeated structures called segments. This periodic pattern is established during embryogenesis by the somitogenesis process. Somites are generated in a rhythmic fashion from the paraxial mesoderm and subsequently differentiate to give rise to the vertebrae and skeletal muscles of the body. Somite formation involves an oscillator-the segmentation clock-whose periodic signal is converted into the periodic array of somite boundaries. This clock drives the dynamic expression of cyclic genes in the presomitic mesoderm and requires Notch and Wnt signaling. Microarray studies of the mouse presomitic mesoderm transcriptome reveal that the segmentation clock drives the periodic expression of a large network of cyclic genes involved in cell signaling. Mutually exclusive activation of the Notch/FGF and Wnt pathways during each cycle suggests that coordinated regulation of these three pathways underlies the clock oscillator. In humans, mutations in the genes associated to the function of this oscillator such as Dll3 or Lunatic Fringe result in abnormal segmentation of the vertebral column such as those seen in congenital scoliosis. Whereas the segmentation clock is thought to set the pace of vertebrate segmentation, the translation of this pulsation into the reiterated arrangement of segment boundaries along the AP axis involves dynamic gradients of FGF and Wnt signaling. The FGF signaling gradient is established based on an unusual mechanism involving mRNA decay which provides an efficient means to couple the spatio-temporal activation of segmentation to the posterior elongation of the embryo. Another striking aspect of somite production is the strict bilateral symmetry of the process. Retinoic acid was shown to control aspects of this coordination by buffering destabilizing effects from the embryonic left-right machinery. Defects in this embryonic program controlling vertebral symmetry might lead

  12. Anomalous origin of the deep brachial artery (profunda brachii observed in bilateral arms: case report Origem anômala da artéria braquial profunda (profunda brachii observada em braços bilaterais: relato de caso

    Directory of Open Access Journals (Sweden)

    Rafael Cisne de Paula

    2013-03-01

    Full Text Available During an ordinary dissection, a cadaver showed a bilateral anomalous origin of the deep brachial artery, where this vessel appeared like a branching of the subscapular artery with common trunk, which included the posterior circumflex humeral artery. The course and distribution of the deep brachial artery in the back compartment were relatively consistent with previous reports. Arterial variations can be damaged through iatrogenic means if not properly documented. The knowledge of this case is very important in clinical medicine and in surgeries in this compartment to prevent any injury.Durante dissecação em prática usual, um cadáver apresentou origem anômala da artéria braquial profunda, na qual este vaso apareceu como um ramo da artéria subescapular com um tronco comum, que incluiu a artéria circunflexa posterior do úmero. O curso e a distribuição da artéria braquial profunda no compartimento posterior foram relativamente coincidentes com relatos prévios. Variações arteriais podem ser danificadas de maneira iatrogênica se não forem adequadamente documentadas. O conhecimento desse caso é muito importante na prática clínica e em cirurgias nesse compartimento para prevenção de qualquer injúria.

  13. The evaluation of vertebrobasilar artery system in neuro-Behçet and Behçet disease using magnetic resonance angiography.

    Science.gov (United States)

    Kose, Evren; Kamisli, Suat; Dogan, Metin; Tasolar, Sevgi; Kahraman, Ayşegül; Oztanir, Mustafa Namik; Sener, Serpil

    2014-07-01

    The aim of this study is the evaluation of the vertebrobasilar artery system in patients with Behçet's and Neuro-Behçet's disease. For this aim; 20 adults with clinically diagnosed Behcet's disease, 20 adults with Neuro-Behçet's disease, and 19 age- and gender-matched controls were examined by magnetic resonance angiography (MRA). During MRA, diameters of left vertebral artery (LVA), right vertebral artery (RVA), basilar artery (BA), and proximal segment (P1) of posterior cerebral artery between origin and junction with the posterior communicating artery were measured. In all groups, LVA was dominant than RVA (P disease were larger than the other groups (P disease were larger but not statistically significant. There is no difference between the groups in terms of gender. Behçet's disease can affect vascular structures; therefore vertebrobasilar artery system should be examined in patients with Behçet's and Neuro-Behçet's disease. © 2014 Wiley Periodicals, Inc.

  14. Angio-RM das artérias carótidas e vertebrais: análise de diferentes técnicas de volume e diluição de contraste em aparelho de 1,0 t e gradiente de 15 mt/m Contrast-enhanced MR angiography of the carotid and vertebral arteries: analysis of different contrast volumes and dilution techniques at 1.0 T with 15 mT/m gradient.

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme C. Hartmann

    2001-08-01

    Full Text Available OBJETIVO: Avaliar as artérias cervicais (carótidas e vertebrais por meio da angio-RM, utilizando-se diferentes dosagens e diluições de contraste paramagnético. MATERIAIS E MÉTODOS: Estudo prospectivo em 15 pacientes, com análise de 30 artérias carótidas comuns, 30 artérias carótidas internas, 30 artérias carótidas externas e 30 artérias vertebrais, utilizando-se diferentes volumes e dosagens de contraste paramagnético: grupo I - dose única (14 ml de Gd-DTPA; grupo II -dose dupla (28 ml de Gd-DTPA; grupo III - dose única e diluída a 50%. A injeção de contraste foi realizada com a utilização de bomba injetora e com velocidades de injeção de 2 ml/s (grupo I e 3 ml/s (grupos II e III. Os segmentos arteriais foram analisados por três examinadores em consenso de forma subjetiva, avaliando-se o grau de visibilidade, intensidade de contrastação e definição de seus contornos. RESULTADOS: Em todos os itens analisados os pacientes do grupo II apresentaram melhor resultado (visibilização total, boa contrastação dos vasos e contornos bem definidos. No grupo I houve boa visibilização das artérias carótidas e vertebrais, porém a intensidade de contraste e a definição dos contornos apresentaram variabilidade qualitativa. O grupo III apresentou os piores resultados, com dificuldade de visibilização, intensidade de contrastação baixa e contornos mal definidos. CONCLUSÃO: Entre os grupos analisados, a técnica utilizando dose dupla de gadolínio é a que permite melhor avaliação das artérias cervicais. A utilização de contraste diluído prejudica a avaliação dos vasos do pescoço.PURPOSE: To evaluate the carotid and vertebral arteries by magnetic resonance angiography, using different contrast volumes and dilution techniques. SUBJECTS AND METHODS: Prospective study of 15 patients, which included the evaluation of 30 common carotid arteries, 30 internal carotid arteries, 30 external carotid arteries and 30

  15. Multi-detector row computed tomographic evaluation of a rare type of complete vascular ring: Double aortic arch with atretic left arch distal to the origin of left subclavian artery

    Energy Technology Data Exchange (ETDEWEB)

    Hung, Ying Ying; Fu, Ching Yun; Wei, Hao Ji; Tsai, I Chen; Chen, Clayton Chi Chang [Taichung Veterans General Hospital, Taichung (China)

    2013-10-15

    Double aortic arch with an atretic left arch distal to the origin of left subclavian artery was diagnosed with multi-detector row computed tomography (MDCT) in two children with dysphagia. This rare type of complete vascular ring is clinically important because it may be confused with right aortic arch in mirror imaging. Anatomic details of this rare type of complete vascular ring demonstrated on MDCT facilitated appropriate surgical treatment.

  16. Evolution of the Twist Subfamily Vertebrate Proteins: Discovery of a Signature Motif and Origin of the Twist1 Glycine-Rich Motifs in the Amino-Terminus Disordered Domain.

    Directory of Open Access Journals (Sweden)

    Yacidzohara Rodriguez

    Full Text Available Twist proteins belong to the basic helix-loop-helix (bHLH family of multifunctional transcriptional factors. These factors are known to use domains other than the common bHLH in protein-protein interactions. There has been much work characterizing the bHLH domain and the C-terminus in protein-protein interactions but despite a few attempts more focus is needed at the N-terminus. Since the region of highest diversity in Twist proteins is the N-terminus, we analyzed the conservation of this region in different vertebrate Twist proteins and study the sequence differences between Twist1 and Twist2 with emphasis on the glycine-rich regions found in Twist1. We found a highly conserved sequence motif in all Twist1 (SSSPVSPADDSLSNSEEE and Twist2 (SSSPVSPVDSLGTSEEE mammalian species with unknown function. Through sequence comparison we demonstrate that the Twist protein family ancestor was "Twist2-like" and the two glycine-rich regions found in Twist1 sequences were acquired late in evolution, apparently not at the same time. The second glycine-rich region started developing first in the fish vertebrate group, while the first glycine region arose afterwards within the reptiles. Disordered domain and secondary structure predictions showed that the amino acid sequence and disorder feature found at the N-terminus is highly evolutionary conserved and could be a functional site that interacts with other proteins. Detailed examination of the glycine-rich regions in the N-terminus of Twist1 demonstrate that the first region is completely aliphatic while the second region contains some polar residues that could be subject to post-translational modification. Phylogenetic and sequence space analysis showed that the Twist1 subfamily is the result of a gene duplication during Twist2 vertebrate fish evolution, and has undergone more evolutionary drift than Twist2. We identified a new signature motif that is characteristic of each Twist paralog and identified

  17. Evolution of the Twist Subfamily Vertebrate Proteins: Discovery of a Signature Motif and Origin of the Twist1 Glycine-Rich Motifs in the Amino-Terminus Disordered Domain.

    Science.gov (United States)

    Rodriguez, Yacidzohara; Gonzalez-Mendez, Ricardo R; Cadilla, Carmen L

    2016-01-01

    Twist proteins belong to the basic helix-loop-helix (bHLH) family of multifunctional transcriptional factors. These factors are known to use domains other than the common bHLH in protein-protein interactions. There has been much work characterizing the bHLH domain and the C-terminus in protein-protein interactions but despite a few attempts more focus is needed at the N-terminus. Since the region of highest diversity in Twist proteins is the N-terminus, we analyzed the conservation of this region in different vertebrate Twist proteins and study the sequence differences between Twist1 and Twist2 with emphasis on the glycine-rich regions found in Twist1. We found a highly conserved sequence motif in all Twist1 (SSSPVSPADDSLSNSEEE) and Twist2 (SSSPVSPVDSLGTSEEE) mammalian species with unknown function. Through sequence comparison we demonstrate that the Twist protein family ancestor was "Twist2-like" and the two glycine-rich regions found in Twist1 sequences were acquired late in evolution, apparently not at the same time. The second glycine-rich region started developing first in the fish vertebrate group, while the first glycine region arose afterwards within the reptiles. Disordered domain and secondary structure predictions showed that the amino acid sequence and disorder feature found at the N-terminus is highly evolutionary conserved and could be a functional site that interacts with other proteins. Detailed examination of the glycine-rich regions in the N-terminus of Twist1 demonstrate that the first region is completely aliphatic while the second region contains some polar residues that could be subject to post-translational modification. Phylogenetic and sequence space analysis showed that the Twist1 subfamily is the result of a gene duplication during Twist2 vertebrate fish evolution, and has undergone more evolutionary drift than Twist2. We identified a new signature motif that is characteristic of each Twist paralog and identified important residues within

  18. Neurofibromatosis-associated massive right internal carotid artery aneurysm with a coexisting arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Marlin Wayne Causey, MD

    2016-12-01

    Full Text Available A 47-year-old woman presented with a right cervical mass that had been slowly enlarging for 6 years, causing pulsatile tinnitus and dizziness with compression. Computed tomography angiography demonstrated a partially thrombosed 8-cm right internal carotid artery aneurysm with a coexisting arteriovenous fistula. Conventional angiography demonstrated a vertebrojugular fistula (right vertebral artery to right internal jugular vein and retrograde flow in the right vertebral artery to the fistula. Successful repair was performed in a staged fashion: operative repair of the internal carotid artery aneurysm with interposition bypass, followed by endovascular embolization of the vertebrojugular fistula through a bilateral vertebral artery approach.

  19. Subclavian artery aneurysm in a patient with vascular Ehlers-Danlos syndrome.

    Science.gov (United States)

    Yasuda, Shota; Imoto, Kiyotaka; Uchida, Keiji; Uranaka, Yasuko; Kurosawa, Kenji; Masuda, Munetaka

    2016-02-01

    We describe our experience of surgical treatment in a 28-year-old woman with vascular Ehlers-Danlos syndrome. A right subclavian artery aneurysm was detected. The right vertebral artery arose from the aneurysm. Digital subtraction angiography showed interruption of the left vertebral artery. The aneurysm was excised and the right vertebral artery was anastomosed end-to-side to the right common carotid artery under deep hypothermia and circulatory arrest. The patient remained very well 4 years after surgery, with no late vascular complication. © The Author(s) 2014.

  20. Radiotherapy of vertebral hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, Kohichi; Hareyama, Masato; Oouchi, Atushi; Sido, Mitsuo; Nagakura, Hisayasu; Tamakawa, Mituharu; Akiba, Hidenari; Morita, Kazuo [Dept. of Radiology, Sapporo Medical Univ., School of Medicine (Japan)

    1997-12-31

    Between 1975 and 1996, 14 patients (11 females, 3 males) with vertebral hemangioma received treatment with radiotherapy. Thirteen patients had a history of back pain or lumbago and 2 patients had neurological symptoms such as sensory impairment or paraplegia. The standard dose administered was 36 Gy in 18 fractions (five treatments per week). In the 13 patients with pain, this was completely or partially relieved. The condition of a man with hypesthesia of the legs deteriorated and a woman with paraplegia who was treated with decompressive laminectomy followed by radiotherapy recovered completely after irradiation. CT scan before irradiation showed thickened trabeculae as small punctate areas of sclerosis in all patients. At MR imaging before irradiation, T2-weighted MR images showed areas of high intensity in all patients and MR images demonstrated lesion enhancement. However, none of the patients who were treated successfully with radiation demonstrated any changes of the affected vertebra in the conventional radiographic films, CT scan or MR imaging, even 5 years after irradiation. Radiological imaging is indispensable for the diagnosis of vertebral hemangiomas but does not appear to be useful for evaluating the effects of radiotherapy. (orig.).

  1. Vertebral contour in spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. S.; Rho, J. C.; Park, J. H.; Choi, H. Y.; Kim, B. K. [Wallace memorial Baptist Hospital, Busan (Korea, Republic of)

    1981-09-15

    The defect in the pars interarticularis of spondylolisthesis may be dependent on contributing factors related to trauma and stress to which the neural arch is subjected, superimposed on a hereditary diasthesis. Posterior wedging of 5th lumber vertebral body in lumbosacral spondylolisthesis together with the degree of slip have been measured. The average wedging in spondylolisthesis is significantly greater than patient without this condition, and forms a characteristic radiological sign. The degree of wedging and slip show a statistically valid correlation. The diagnosis of spondylolisthesis is becoming more prevalent as the complexity of our society result in the increasing use of roentgenography of the lumbar spine. Isolated lateral deviation and rotation of spinous process seen in anteroposterior radiographs of the lumbar spine seems to be associated with pathology in the pars interarticularis.

  2. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  3. [About evolution of sleep-wakefulness cycle in vertebrates].

    Science.gov (United States)

    Oganesian, G A; Aristakesian, E A; Vataev, S I

    2012-10-01

    Data about behavioral, somato-vegetative and neurophysiological parameters of sleep and wakefulness in insects, cold- and warm-blooded vertebrates are provided. Hypotheses existing now about evolutionary formation of separate sleep phases and stages in vertebrates are considered. In the review are shown the data about correlations of quantitative characteristics of sleep and wake in some mammals with basic metabolic rate, lifestyle, environmental habits. The original experimental results at formation of neurophysiological characteristics of sleep and wake in vertebrates, phylogeny and in ontogeny of mature and immature mammals are provided in detail. On the basis of own concepts about evolutionary development of sleep-wakefulness cycle in vertebrates the interactions of telencephalic, diencephalic and rhombencepalic parts of brain in the processes of cycle wakefulness cycle integration are discussed.

  4. Coronary intervention in anomalous origin of the right coronary artery (ARCA from the left sinus of valsalva (LSOV: A single center experience

    Directory of Open Access Journals (Sweden)

    Kalaichelvan Uthayakumaran

    2014-07-01

    Conclusion: PCI of anomalous RCA origin from LSOV requires appropriate guide catheter selection according to the anatomy of origin for successful cannulation and to reduce the contrast usage and radiation exposure.

  5. Mid-infrared pulsed laser ablation of the arterial wall. Mechanical origin of "acoustic" wall damage and its effect on wall healing

    NARCIS (Netherlands)

    van Erven, L.; van Leeuwen, T. G.; Post, M. J.; van der Veen, M. J.; Velema, E.; Borst, C.

    1992-01-01

    Pulsed mid-infrared lasers are an alternative to excimer lasers for transluminal angioplasty. The mid-infrared lasers, however, were reported to produce "acoustic" wall damage that might impair the immediate and long-term results. To study the immediate and long-term effects on the arterial wall,

  6. The timing of Timezyme diversification in vertebrates.

    Directory of Open Access Journals (Sweden)

    Damien Cazaméa-Catalan

    Full Text Available All biological functions in vertebrates are synchronized with daily and seasonal changes in the environment by the time keeping hormone melatonin. Its nocturnal surge is primarily due to the rhythmic activity of the arylalkylamine N-acetyl transferase AANAT, which thus became the focus of many investigations regarding its evolution and function. Various vertebrate isoforms have been reported from cartilaginous fish to mammals but their origin has not been clearly established. Using phylogeny and synteny, we took advantage of the increasing number of available genomes in order to test whether the various rounds of vertebrate whole genome duplications were responsible for the diversification of AANAT. We highlight a gene secondary loss of the AANAT2 in the Sarcopterygii, revealing for the first time that the AAANAT1/2 duplication occurred before the divergence between Actinopterygii (bony fish and Sarcopterygii (tetrapods, lobe-finned fish, and lungfish. We hypothesize the teleost-specific whole genome duplication (WDG generated the appearance of the AANAT1a/1b and the AANAT2/2'paralogs, the 2' isoform being rapidly lost in the teleost common ancestor (ray-finned fish. We also demonstrate the secondary loss of the AANAT1a in a Paracantopterygii (Atlantic cod and of the 1b in some Ostariophysi (zebrafish and cave fish. Salmonids present an even more diverse set of AANATs that may be due to their specific WGD followed by secondary losses. We propose that vertebrate AANAT diversity resulted from 3 rounds of WGD followed by previously uncharacterized secondary losses. Extant isoforms show subfunctionalized localizations, enzyme activities and affinities that have increased with time since their emergence.

  7. Differentiating malignant vertebral tumours from non-malignancies with CT spectral imaging: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Yuan; Zhang, Yan; Lang, Ning; Yuan, Huishu [Peking University Third Hospital, No.49 North Garden Street, Haidian District, Beijing (China); Li, Jianying [GE Healthcare, CT imaging Research Center, Beijing (China)

    2015-10-15

    To investigate the value of dual-energy spectral computed tomography (DESCT) for differentiating malignant vertebral tumours from non-malignancies during venous phase. This study was institutional review board-approved, and written informed consent was obtained from all patients. Thirty-seven patients were examined by DESCT during venous phase. Twenty patients had malignant vertebral tumours, 17 had non-malignant vertebral tumours. The iodine/water densities for the lesion, the lesion-to-muscle ratio, and lesion-to-artery ratio for iodine density measurements were calculated and compared between the two groups with the two-tailed Student t test. A p-value < 0.05 was considered statistically significant. Sensitivity and specificity were compared between the qualitative and quantitative studies. The iodine density, lesion-to-muscle ratio, and lesion-to-artery ratio of the iodine density measurement for malignant vertebral tumours were significantly different from the respective values for non-malignancies (all p < 0.05). Using 0.52 as the threshold value for the lesion-to-artery iodine density ratio, one could obtain sensitivity of 85 % and specificity of 100 % for differentiating malignant vertebral tumours from non-malignancies, significantly higher than the qualitative diagnosis. DESCT imaging enables analysis of a number of additional quantitative CT parameters to improve the accuracy for differentiating malignant vertebral tumours from non-malignancies during venous phase. (orig.)

  8. Vertebral Malformations in French Bulldogs

    OpenAIRE

    KURICOVÁ, Mária; LEDECKÝ, Valent; KVETKOVÁ, Jaroslava; LIPTÁK, Tomáš

    2017-01-01

    The aim of this study was to detect vertebral malformations among French Bulldogs admitted between the years 2011 – 2016 due to the high popularity of the breed and the intentions to increase the breed welfare by reducing the occurrence of congenital anomalies. Besides, we aimed to look for gender predisposition, possible vertebral predisposition, occurrence of clinical symptoms and radiographic findings. A total of 73 French Bulldogs met the inclusion criteria (radiographs of the whole spine...

  9. [Sports-related carotid artery dissection].

    Science.gov (United States)

    Berrouschot, J; Bormann, A; Routsi, D; Stoll, A

    2009-09-01

    Sports-related carotid artery dissection are very rare and were described in different kinds of sports. We report on a 45-year old man who suffered bilateral brain infarctions caused by bilateral extracranial internal carotid artery dissection after excessive weight lifting in a gym. As possible trigger factors for the dissections we assumed the abrupt extension of the neck during weight lifting and the frequent Valsalva manoeuvers with massive rise in the pressure in the carotid artery system. The patient underwent angioplasty and stenting of the stenosis of right carotid artery, the primarily occluded left carotid artery recanalized spontaneously. Secondary prevention was established by platelet aggregation inhibitors. The patient recovered completely. The pathogenesis of sports-related dissections is multifactorial. In addition to sporting activities hereditary or acquired structural aberrations in the arterial walls could be discussed. Acute focal neurological symptoms after sport should always focus on carotid or vertebral artery dissection. (c) Georg Thieme Verlag KG Stuttgart-New York.

  10. Double renal artery originating from aorta in dog: case report/
    Artéria renal dupla originando da aorta em cão: relato de caso

    OpenAIRE

    Marcelo Abidu-Figueiredo; Luciano da Silva Alonso

    2008-01-01

    The presence of the multiple renal artery in dogs, supplying the left kidney, has been reported in 12-15%. New surgery technics in the urogenital tract and the utilization of model for renal transplantation are of clinical significance when considering surgery of that kidney. Courses of anatomy directed veterinary medicine and animal anatomy for students of courses of graduation in the areas of agrarian and biological sciences, use anatomical material proceeding from domestic animals in consi...

  11. DMRT genes in vertebrate gametogenesis.

    Science.gov (United States)

    Zarkower, David

    2013-01-01

    Genes containing the DM domain DNA-binding motif regulate sex determination and sexual differentiation in a broad variety of metazoans, including nematodes, insects, and vertebrates. They can function in primary sex determination or downstream in sexual differentiation, and they can act either throughout the body or in highly restricted cell types. In vertebrates, several DM domain genes--DMRT genes--play critical roles in gonadal differentiation or gametogenesis. DMRT1 has the most prominent role and likely regulates testicular differentiation in all vertebrates. In the mammalian gonad, DMRT1 exerts both intrinsic and extrinsic control of gametogenesis; it is required for germ cell differentiation in males and regulates meiosis in both sexes, and it is required in supporting cells for the establishment and maintenance of male fate in the testis. These varied functions of DMRT1 serve to coordinate gonadal development and function. In other vertebrates, DMRT1 regulates gonadal differentiation, and it also appears to have played a central role in the evolution of new sex-determining mechanisms in at least three vertebrate clades. This chapter focuses on the regulation of vertebrate gametogenesis by DMRT1. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Vascular development in the vertebrate pancreas.

    Science.gov (United States)

    Azizoglu, D Berfin; Chong, Diana C; Villasenor, Alethia; Magenheim, Judith; Barry, David M; Lee, Simon; Marty-Santos, Leilani; Fu, Stephen; Dor, Yuval; Cleaver, Ondine

    2016-12-01

    The vertebrate pancreas is comprised of a highly branched tubular epithelium, which is intimately associated with an extensive and specialized vasculature. While we know a great deal about basic vascular anatomy of the adult pancreas, as well as islet capillaries, surprisingly little is known about the ontogeny of its blood vessels. Here, we analyze development of the pancreatic vasculature in the mouse embryo. We show that pancreatic epithelial branches intercalate with the fine capillary plexus of the surrounding pancreatic mesenchyme. Endothelial cells (ECs) within this mesenchyme are heterogeneous from the onset of organogenesis. Pancreatic arteries take shape before veins, in a manner analogous to early embryonic vessels. The main central artery forms during mid-gestation, as a result of vessel coalescence and remodeling of a vascular plexus. In addition, we show that vessels in the forming pancreas display a predictable architecture that is dependent on VEGF signaling. Over-expression of VEGF disrupts vascular patterning and arteriovenous differentiation within the developing pancreas. This study constitutes a first-time in-depth cellular and molecular characterization of pancreatic blood vessels, as they coordinately grow along with the pancreatic epithelium. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B

    2009-10-01

    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

  14. Vertebrate reservoirs of arboviruses: myth, synonym of amplifier, or reality?

    Czech Academy of Sciences Publication Activity Database

    Kuno, G.; Mackenzie, J. S.; Junglen, S.; Hubálek, Zdeněk; Plyusnin, A.; Gubler, D. J.

    2017-01-01

    Roč. 9, č. 7 (2017), č. článku 185. ISSN 1999-4915 Institutional support: RVO:68081766 Keywords : insect-specific virus * arbovirus * transmission mechanism * vertebrate reservoir * origin of arbovirus * virus maintenance * zoonosis * host range Subject RIV: EE - Microbiology, Virology Impact factor: 3.465, year: 2016

  15. Domain combination of the vertebrate-like TLR gene family ...

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Journals; Journal of Genetics; Volume 90; Issue 3. Domain combination of the vertebrate-like TLR gene family: implications for their origin and evolution. Baojun Wu Tianxiao Huan Jing Gong Pin Zhou Zengliang Bai. Research Article Volume 90 Issue 3 December ...

  16. A middle mesenteric artery

    OpenAIRE

    Milnerowicz, Stanislaw; Milnerowicz, Artur; Taboła, Renata

    2012-01-01

    In 114 cases of the transverse colon isolated from cadavers (50 male, 64 female), anatomical examinations of the arterial system of the colon were performed. Arteriograms were obtained after dissecting and contrasting the colonic vessels with Mixobar contrast. In one case, on arteriography of the colon with its mesentery isolated from a 55-year-old male cadaver, a rare anatomical variant was found. The third mesenteric artery originated directly from the aorta—halfway between the superior and...

  17. Countercurrent aortography via radial artery

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1987-06-15

    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  18. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  19. Blood flow distribution in cerebral arteries.

    Science.gov (United States)

    Zarrinkoob, Laleh; Ambarki, Khalid; Wåhlin, Anders; Birgander, Richard; Eklund, Anders; Malm, Jan

    2015-03-31

    High-resolution phase-contrast magnetic resonance imaging can now assess flow in proximal and distal cerebral arteries. The aim of this study was to describe how total cerebral blood flow (tCBF) is distributed into the vascular tree with regard to age, sex and anatomic variations. Forty-nine healthy young (mean 25 years) and 45 elderly (mean 71 years) individuals were included. Blood flow rate (BFR) in 21 intra- and extracerebral arteries was measured. Total cerebral blood flow was defined as BFR in the internal carotid plus vertebral arteries and mean cerebral perfusion as tCBF/brain volume. Carotid/vertebral distribution was 72%/28% and was not related to age, sex, or brain volume. Total cerebral blood flow (717 ± 123 mL/min) was distributed to each side as follows: middle cerebral artery (MCA), 21%; distal MCA, 6%; anterior cerebral artery (ACA), 12%, distal ACA, 4%; ophthalmic artery, 2%; posterior cerebral artery (PCA), 8%; and 20% to basilar artery. Deviating distributions were observed in subjects with 'fetal' PCA. Blood flow rate in cerebral arteries decreased with increasing age (Psystem.

  20. Coronary Artery Anomalies in Animals

    Directory of Open Access Journals (Sweden)

    Brian A. Scansen

    2017-04-01

    Full Text Available Coronary artery anomalies represent a disease spectrum from incidental to life-threatening. Anomalies of coronary artery origin and course are well-recognized in human medicine, but have received limited attention in veterinary medicine. Coronary artery anomalies are best described in the dog, hamster, and cow though reports also exist in the horse and pig. The most well-known anomaly in veterinary medicine is anomalous coronary artery origin with a prepulmonary course in dogs, which limits treatment of pulmonary valve stenosis. A categorization scheme for coronary artery anomalies in animals is suggested, dividing these anomalies into those of major or minor clinical significance. A review of coronary artery development, anatomy, and reported anomalies in domesticated species is provided and four novel canine examples of anomalous coronary artery origin are described: an English bulldog with single left coronary ostium and a retroaortic right coronary artery; an English bulldog with single right coronary ostium and transseptal left coronary artery; an English bulldog with single right coronary ostium and absent left coronary artery with a prepulmonary paraconal interventricular branch and an interarterial circumflex branch; and a mixed-breed dog with tetralogy of Fallot and anomalous origin of all coronary branches from the brachiocephalic trunk. Coronary arterial fistulae are also described including a coronary cameral fistula in a llama cria and an English bulldog with coronary artery aneurysm and anomalous shunting vessels from the right coronary artery to the pulmonary trunk. These examples are provided with the intent to raise awareness and improve understanding of such defects.

  1. Third-generation percutaneous vertebral augmentation systems

    OpenAIRE

    Vanni, Daniele; Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo

    2016-01-01

    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater...

  2. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  3. Pregnancy related symptomatic vertebral hemangioma

    Directory of Open Access Journals (Sweden)

    Meena Gupta

    2014-01-01

    Full Text Available Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  4. THE COMPARATIVE STUDY OF EFFICACY AND TOLERABILITY OF GENERIC AND ORIGINAL VALSARTAN AS A MONOTHERAPY OR IN COMBINATION WITH HYDROCHLOROTHIAZIDE AND BISOPROLOL IN PATIENTS WITH ARTERIAL HYPERTENSION OF 1-2 DEGREE AND METABOLIC SYNDROME

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-12-01

    Full Text Available Aim. To study the efficacy and safety of generic valsartan Valz (Actavis Group, Iceland in comparison with the original valsartan Diovan® (Novartis, Switzerland in patients with arterial hypertension (HT of 1-2 degrees and metabolic syndrome. Material and Methods. 30 hypertensive patients (12 men and 18 women were enrolled in a randomized open-label crossover study. Each patient received generic and original valsartan (80 mg QD sequentially during 8 weeks. When target blood pressure (BP level (<130/80 mm Hg was not reached, a fixed combination of valsartan with hydrochlorothiazide (80/12.5 mg, and then 160/12.5 mg, and bisoprolol 5 mg/daily , if necessary , were used. Treatment efficacy and safety was assessed at visit to doctor every 2 weeks throughout the study. The sequence of drug use was determined by randomization. Results. Systolic BP (SBP decreased by 27.5 and 27.4 mm Hg from baseline due to generic and original valsartan 8 week treatment, respectively. Diastolic BP (DBP decreased by 12.8 and 12.9 mm Hg , respectively (p>0.05. Target BP was achieved in 23 patients (77% in both randomized groups. Serious adverse reaction were not observed during the treatment with both valsartan drugs. Conclusion. The therapeutic equivalence of generic and original valsartan drugs is shown. Therapy based on valsartan (in combination was safe and effective in 77% of patients with HT of 1-2 degrees and metabolic syndrome.

  5. THE COMPARATIVE STUDY OF EFFICACY AND TOLERABILITY OF GENERIC AND ORIGINAL VALSARTAN AS A MONOTHERAPY OR IN COMBINATION WITH HYDROCHLOROTHIAZIDE AND BISOPROLOL IN PATIENTS WITH ARTERIAL HYPERTENSION OF 1-2 DEGREE AND METABOLIC SYNDROME

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2012-01-01

    Full Text Available Aim. To study the efficacy and safety of generic valsartan Valz (Actavis Group, Iceland in comparison with the original valsartan Diovan® (Novartis, Switzerland in patients with arterial hypertension (HT of 1-2 degrees and metabolic syndrome. Material and Methods. 30 hypertensive patients (12 men and 18 women were enrolled in a randomized open-label crossover study. Each patient received generic and original valsartan (80 mg QD sequentially during 8 weeks. When target blood pressure (BP level (<130/80 mm Hg was not reached, a fixed combination of valsartan with hydrochlorothiazide (80/12.5 mg, and then 160/12.5 mg, and bisoprolol 5 mg/daily , if necessary , were used. Treatment efficacy and safety was assessed at visit to doctor every 2 weeks throughout the study. The sequence of drug use was determined by randomization. Results. Systolic BP (SBP decreased by 27.5 and 27.4 mm Hg from baseline due to generic and original valsartan 8 week treatment, respectively. Diastolic BP (DBP decreased by 12.8 and 12.9 mm Hg , respectively (p>0.05. Target BP was achieved in 23 patients (77% in both randomized groups. Serious adverse reaction were not observed during the treatment with both valsartan drugs. Conclusion. The therapeutic equivalence of generic and original valsartan drugs is shown. Therapy based on valsartan (in combination was safe and effective in 77% of patients with HT of 1-2 degrees and metabolic syndrome.

  6. Sequencing of the sea lamprey (Petromyzon marinus) genome provides insights into vertebrate evolution

    Science.gov (United States)

    Smith, Jeramiah J; Kuraku, Shigehiro; Holt, Carson; Sauka-Spengler, Tatjana; Jiang, Ning; Campbell, Michael S; Yandell, Mark D; Manousaki, Tereza; Meyer, Axel; Bloom, Ona E; Morgan, Jennifer R; Buxbaum, Joseph D; Sachidanandam, Ravi; Sims, Carrie; Garruss, Alexander S; Cook, Malcolm; Krumlauf, Robb; Wiedemann, Leanne M; Sower, Stacia A; Decatur, Wayne A; Hall, Jeffrey A; Amemiya, Chris T; Saha, Nil R; Buckley, Katherine M; Rast, Jonathan P; Das, Sabyasachi; Hirano, Masayuki; McCurley, Nathanael; Guo, Peng; Rohner, Nicolas; Tabin, Clifford J; Piccinelli, Paul; Elgar, Greg; Ruffier, Magali; Aken, Bronwen L; Searle, Stephen MJ; Muffato, Matthieu; Pignatelli, Miguel; Herrero, Javier; Jones, Matthew; Brown, C Titus; Chung-Davidson, Yu-Wen; Nanlohy, Kaben G; Libants, Scot V; Yeh, Chu-Yin; McCauley, David W; Langeland, James A; Pancer, Zeev; Fritzsch, Bernd; de Jong, Pieter J; Zhu, Baoli; Fulton, Lucinda L; Theising, Brenda; Flicek, Paul; Bronner, Marianne E; Warren, Wesley C; Clifton, Sandra W; Wilson, Richard K; Li, Weiming

    2013-01-01

    Lampreys are representatives of an ancient vertebrate lineage that diverged from our own ~500 million years ago. By virtue of this deeply shared ancestry, the sea lamprey (P. marinus) genome is uniquely poised to provide insight into the ancestry of vertebrate genomes and the underlying principles of vertebrate biology. Here, we present the first lamprey whole-genome sequence and assembly. We note challenges faced owing to its high content of repetitive elements and GC bases, as well as the absence of broad-scale sequence information from closely related species. Analyses of the assembly indicate that two whole-genome duplications likely occurred before the divergence of ancestral lamprey and gnathostome lineages. Moreover, the results help define key evolutionary events within vertebrate lineages, including the origin of myelin-associated proteins and the development of appendages. The lamprey genome provides an important resource for reconstructing vertebrate origins and the evolutionary events that have shaped the genomes of extant organisms. PMID:23435085

  7. Drug Eluting Stents for Symptomatic Intracranial and Vertebral Artery Stenosis

    OpenAIRE

    Fields, J.D.; Petersen, B.D.; Lutsep, H.L.; Nesbit, G.M.; K. C. Liu; Dogan, A; Lee, D S; Clark, W. M.; Barnwell, S L

    2011-01-01

    The use of bare metal stents (BMS) to prevent recurrent stroke due to stenosis of the cerebral vasculature is associated with high rates of restenosis. Drug-eluting stents (DES) may decrease this risk. We evaluated the performance of DES in a cohort of patients treated at our institution.

  8. Vertebral artery dissection associated with generalized convulsive seizures

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Larsen, Vibeke Andrée; Tfelt-Hansen, Peer

    2013-01-01

    A 46-year-old male with juvenile myoclonic epilepsy was admitted to the neurological department for convulsive seizures just after lamotrigine was discontinued. On admission he was awake but had a right-sided hemiparesis with Babinski sign and ataxic finger-nose test on the left side. An MR scan...

  9. Vertebral Artery Thrombosis in Chronic Idiopathic Thrombocytopenic Purpura.

    Science.gov (United States)

    Hindi, Zakaria; Onteddu, Nirmal; Ching, Christopher A; Khaled, Abdallah A

    2017-01-01

    Immune thrombocytopenic purpura (ITP) is an autoimmune hematological disorder that causes decreased production and destruction of platelets leading to thrombocytopenia. Although thrombocytopenia usually causes hemorrhagic problems, thrombotic events like strokes, although rare, can still occur. Management of thrombotic events in patients with ITP differs from that of patients with normal platelet count function and count. A 32-year-old female with a history of ITP presented with ischemic stroke. The patient was treated in the hospital with IV immunoglobulin, discharged to a rehabilitation facility, and had complete resolution of symptoms when examined at a follow-up visit 3 months later. Although stroke in patients with ITP is very rare due to thrombocytopenia, it has been reported in several other published cases and is likely associated with increased platelet microparticle levels, a byproduct of platelet destruction. While usage of antiplatelet therapy in such patients is debated, immunosuppression therapy has been the mainstay treatment in all published cases.

  10. A case report of intracranial vertebral-basilar artery hypoplasia ...

    African Journals Online (AJOL)

    It accompanied with headache, bilateral tinnitus and blurred vision. Time-of-flight magnetic resonance angiogram with T2 true fast imaging in steady state precession confirmed the VBAH, rather than a stenosis. Symptoms subsided after daily oral aspirin and life-style change has been recommended for three months.

  11. Vertebrate pressure-gradient receivers

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob

    2011-01-01

    The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum and stro......The eardrums of all terrestrial vertebrates (tetrapods) are connected through Eustachian tubes or interaural canals. In some of the animals, these connections create pressure-gradient directionality, an enhanced directionality by interaction of sound arriving at both sides of the eardrum....... Recent vertebrates form a continuum from perfect interaural transmission (0 dB in a certain frequency band) and pronounced eardrum directionality (30-40 dB) in the lizards, over somewhat attenuated transmission and limited directionality in birds and frogs, to the strongly attenuated interaural...

  12. Anomalous left the pulmonary dilemma coronary artery artery from a ...

    African Journals Online (AJOL)

    ; 8: 787-80I. 6. Wilson CL, Dlabal PW, Holeyfield RW, Akins CW, Knauf DG. Anomalous origin of left coronary artery from pulmonary artery: case report and review of. lileralUre concerning teenagers and adults.J Thorac Cardicn'asc SlIrg 1977; ...

  13. Elbow dislocation with ipsilateral fracture of the distal radius associated with a brachial artery injury: A new pathological condition of traumatic origin.

    Science.gov (United States)

    Trigo Lahoz, L; Lamas Gomez, C; Sarasquete Reiriz, J; de Caso Rodriguez, J; Proubasta Renart, I

    Elbow dislocation associated with ipsilateral fracture of the distal radius and a brachial artery injury is an uncommon traumatic entity. The two references of this injury combination appeared in 2015, although both authors did not realise that they were the first two cases published in the medical literature. Although mentioned in the text of the articles, no mention was made of the fracture of the distal radius in the titles. The purpose of this paper is to present three cases with this new traumatic pathological entity, explaining its pathogenetic mechanism, the treatment used, and the results obtained. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Vascularização arterial da região do nó sinoatrial em corações suínos: origem, distribuição e quantificação Arterial vascularization of the sinoatrial node in swine hearts: origin, distribution and quantification

    Directory of Open Access Journals (Sweden)

    Ana P. Vidotti

    2008-02-01

    superfície de área (Sv foi de 182 e a superfície de área (S - mm² - foi de 64,3x10(6µm². A estimação da densidade numérica vascular (Nv(vasc, quantidade de vasos por unidade de volume (cm³, foi de 2,19 10-5 e o número total de vasos no órgão (N(vasc, estimado pelo método dissector físico em combinação com a estimativa do número de Euler (Xv, foi de 773,6832 x10-2. A elevada densidade vascular e do número total de vasos na região do nó sinoatrial de suínos sugere a existência de uma complexa e densa rede vascular perinodal, ratificando a importância deste marca-passo pelo seu suprimento sangüíneo.The sinoatrial node, for being topographically installed as the initial component of the conduction system, is responsible for the production of the nervous impulses, which determines the cardiac contraction. There have been made studies related to the node's morphology in order to know the origin, distribution and quantification of the vases in this tissue, however, in spite of the results and quantitative data of the nodal irrigation - arterial vascular conduct and arterial vascular density, at the nodal level - the literature is scarce. With this objective 27 SRD swine hearts, injected with colored resin for macroscopic analysis of the origin and distribution of ANSA (sinoatrial node artery, 3 others injected with watery solution of colloidal coal (dyed nanquim were used, to mark the route of the vases on the node level for stereological analysis. The atrial arteries originated as well from the right coronary artery as from the left one, with predominance of the first (66.66% and 33.33%, respectively. When originated from the right coronary artery, there existed the following branches: AADAM (right cranial medial atrial artery in 14 cases, AADAI (right cranial intermedial atrial artery in 2 cases, and AADAL (right cranial lateral atrial artery in 2 cases. In 9 cases (33.33% the following branches originated from the left coronary artery: 4 through

  15. [No role for oral anticoagulants (target INR: 2.0-3.0) after transient ischaemic attack or cerebral infarction of arterial origin; the 'European/Australasian stroke prevention in reversible ischaemia trial' (ESPRIT)].

    Science.gov (United States)

    De Schryver, E L L M; Halkes, P H A

    2008-02-23

    The 'European/Australasian stroke prevention in reversible ischaemia trial' (ESPRIT) aimed to determine whether oral anticoagulation of moderate intensity (target international normalised ratio (INR): 2.0-3.0) is more effective than acetylsalicylic acid in preventing future vascular events in patients with transient ischaemic attack (TIA) or minor stroke of arterial origin. International, multicentre randomised clinical trial. Patients were randomised within 6 months of TIA or minor stroke of arterial origin to oral anticoagulants (target INR: 2.0-3.0; n = 536) or acetylsalicylic acid (30-325 mg daily; n = 532). The primary endpoint was a composite of vascular death, non-fatal stroke, non-fatal myocardial infarction or major bleeding complications. In a post hoc analysis, the efficacy of anticoagulants was compared with that of the combination of acetylsalicylic acid and dipyridamole (200 mg twice daily), a third arm of ESPRIT. Treatment was unblinded, but auditing of endpoints was blinded. Data were analysed on an intent-to-treat basis. The comparison of anticoagulants and acetylsalicylic acid was stopped prematurely because the combination of acetylsalicylic acid and dipyridamole was found to be more effective than acetylsalicylic acid alone. The mean duration of follow-up was 4.6 years (SD: 2.2). The mean INR was 2.57 (SD: 0.86; nearly 70% of the time within target range). The primary endpoint occurred in 99 patients (19%) in the anticoagulation group and 98 patients (18%) in the acetylsalicylic acid group (hazard ratio: 1.02; 95% CI: 0.77-1.35). The hazard ratio was 0.73 (95% CI: 0.52-1.01) for ischaemic events and 2.56 (95% CI: 1.48-4.43) for major bleeding complications. The hazard ratio for the primary outcome event comparing anticoagulants with the combination of acetylsalicylic acid and dipyridamole was 1.31 (95% CI: 0.98-1.75). Oral anticoagulants (target INR: 2.0-3.0) were not more effective than acetylsalicylic acid in the secondary prevention of

  16. Insights from amphioxus into the evolution of vertebrate cartilage.

    Directory of Open Access Journals (Sweden)

    Daniel Meulemans

    2007-08-01

    Full Text Available Central to the story of vertebrate evolution is the origin of the vertebrate head, a problem difficult to approach using paleontology and comparative morphology due to a lack of unambiguous intermediate forms. Embryologically, much of the vertebrate head is derived from two ectodermal tissues, the neural crest and cranial placodes. Recent work in protochordates suggests the first chordates possessed migratory neural tube cells with some features of neural crest cells. However, it is unclear how and when these cells acquired the ability to form cellular cartilage, a cell type unique to vertebrates. It has been variously proposed that the neural crest acquired chondrogenic ability by recruiting proto-chondrogenic gene programs deployed in the neural tube, pharynx, and notochord. To test these hypotheses we examined the expression of 11 amphioxus orthologs of genes involved in neural crest chondrogenesis. Consistent with cellular cartilage as a vertebrate novelty, we find that no single amphioxus tissue co-expresses all or most of these genes. However, most are variously co-expressed in mesodermal derivatives. Our results suggest that neural crest-derived cartilage evolved by serial cooption of genes which functioned primitively in mesoderm.

  17. Evolution of the Vertebrate Resistin Gene Family.

    Directory of Open Access Journals (Sweden)

    Qingda Hu

    Full Text Available Resistin (encoded by Retn was previously identified in rodents as a hormone associated with diabetes; however human resistin is instead linked to inflammation. Resistin is a member of a small gene family that includes the resistin-like peptides (encoded by Retnl genes in mammals. Genomic searches of available genome sequences of diverse vertebrates and phylogenetic analyses were conducted to determine the size and origin of the resistin-like gene family. Genes encoding peptides similar to resistin were found in Mammalia, Sauria, Amphibia, and Actinistia (coelacanth, a lobe-finned fish, but not in Aves or fish from Actinopterygii, Chondrichthyes, or Agnatha. Retnl originated by duplication and transposition from Retn on the early mammalian lineage after divergence of the platypus, but before the placental and marsupial mammal divergence. The resistin-like gene family illustrates an instance where the locus of origin of duplicated genes can be identified, with Retn continuing to reside at this location. Mammalian species typically have a single copy Retn gene, but are much more variable in their numbers of Retnl genes, ranging from 0 to 9. Since Retn is located at the locus of origin, thus likely retained the ancestral expression pattern, largely maintained its copy number, and did not display accelerated evolution, we suggest that it is more likely to have maintained an ancestral function, while Retnl, which transposed to a new location, displays accelerated evolution, and shows greater variability in gene number, including gene loss, likely evolved new, but potentially lineage-specific, functions.

  18. Permo-Triassic vertebrate extinctions: A program

    Science.gov (United States)

    Olson, E. C.

    1988-01-01

    Since the time of the Authors' study on this subject, a great deal of new information has become available. Concepts of the nature of extinctions have changed materially. The Authors' conclusion that a catastrophic event was not responsible for the extinction of vertebrates has modified to the extent that hypotheses involving either the impact of a massive extra-terrestrial body or volcanism provide plausible but not currently fully testable hypotheses. Stated changes resulted in a rapid decrease in organic diversity, as the ratio of origins of taxa to extinctions shifted from strongly positive to negative, with momentary equilibrium being reached at about the Permo-Triassic boundary. The proximate causes of the changes in the terrestrial biota appear to lie in two primary factors: (1) strong climatic changes (global mean temperatures, temperature ranges, humidity) and (2) susceptibility of the dominant vertebrates (large dicynodonts) and the glossopteris flora to disruption of the equlibrium of the world ecosystem. The following proximate causes have been proposed: (1) rhythmic fluctuations in solar radiation, (2) tectonic events as Pangea assembled, altering land-ocean relationships, patterns of wind and water circulation and continental physiography, (3) volcanism, and (4) changes subsequent to impacts of one or more massive extra terrestrial objects, bodies or comets. These hypotheses are discussed.

  19. The characters of Palaeozoic jawed vertebrates.

    Science.gov (United States)

    Brazeau, Martin D; Friedman, Matt

    2014-04-01

    Newly discovered fossils from the Silurian and Devonian periods are beginning to challenge embedded perceptions about the origin and early diversification of jawed vertebrates (gnathostomes). Nevertheless, an explicit cladistic framework for the relationships of these fossils relative to the principal crown lineages of the jawed vertebrates (osteichthyans: bony fishes and tetrapods; chondrichthyans: sharks, batoids, and chimaeras) remains elusive. We critically review the systematics and character distributions of early gnathostomes and provide a clearly stated hierarchy of synapomorphies covering the jaw-bearing stem gnathostomes and osteichthyan and chondrichthyan stem groups. We show that character lists, designed to support the monophyly of putative groups, tend to overstate their strength and lack cladistic corroboration. By contrast, synapomorphic hierarchies are more open to refutation and must explicitly confront conflicting evidence. Our proposed synapomorphy scheme is used to evaluate the status of the problematic fossil groups Acanthodii and Placodermi, and suggest profitable avenues for future research. We interpret placoderms as a paraphyletic array of stem-group gnathostomes, and suggest what we regard as two equally plausible placements of acanthodians: exclusively on the chondrichthyan stem, or distributed on both the chondrichthyan and osteichthyan stems.

  20. [Gynogenesis in vertebrates].

    Science.gov (United States)

    Chourrout, D

    1982-01-01

    After a rapid description of five gynogenetic unisexual species, this paper reviews the methods used for inducing gynogenesis in bisexual species. 1) The frequency of male genome extrusion, very low after intraspecific mating, can be appreciably increased in some particular interspecific combinations; cold-shocking the eggs at the time of fertilization can also result in gynogenetic development. In the case, of mammals, the male pronucleus can be microsurgically removed, but in most cases (amphibians, fish), haploid gynogenesis is induced by mutagenic treatment of the sperm (gamma, X, UV irradiation; chemicals) before fertilization. 2) Viable gynogenesis depends on the possibility of diploidizing the female genetic set; several factors (oocyte aging, genetic factors, induction of ovulation) may be responsible for the high frequency of "spontaneous" diploidization reported in some studies. But diploid gynogenesis is generally obtained by induced retention of the second polar body or by induced suppression of the first cleavage, achieved by heat or pressure treatment of eggs (fish and amphibians) or by the use of antimitotic chemicals (mammals). Diploid gynegenesis results in high inbreeding levels and original sex ratios. In the discussion, we have tried to show that the objectives which stimulated its induction in amphibians have been frequently unattained or reached in other ways. In commercial fish species, gynogenesis may in the future contribute to the solution of major problems such as genetic improvement and control of reproduction.

  1. Dupla meningocele na coluna vertebral

    Directory of Open Access Journals (Sweden)

    Ehrenfried O. Wittig

    1968-03-01

    Full Text Available É relatado caso de dupla meningocele de coluna vertebral, respectivamente nas regiões cervico-torácica e tóraco-lombar, no qual ocorreu hidrocéfalo após pneumoventriculografia. Para a compensação do hidrocéfalo foi feita drenagem ventrículo-peritonial.

  2. Symptomatic vertebral hemangiomas during pregnancy.

    Science.gov (United States)

    Moles, Alexis; Hamel, Olivier; Perret, Christophe; Bord, Eric; Robert, Roger; Buffenoir, Kevin

    2014-05-01

    Symptomatic vertebral hemangiomas during pregnancy are rare, as only 27 cases have been reported in the literature since 1948. However, symptomatic vertebral hemangiomas can be responsible for spinal cord compression, in which case they constitute a medical emergency, which raises management difficulties in the context of pregnancy. Pregnancy is a known factor responsible for deterioration of these vascular tumors. In this paper, the authors report 2 clinical cases of symptomatic vertebral hemangiomas during pregnancy, including 1 case of spontaneous fracture that has never been previously reported in the literature. The authors then present a brief review of the literature to discuss emergency management of this condition. The first case was a 28-year-old woman at 35 weeks of gestation, who presented with paraparesis. Spinal cord MRI demonstrated a vertebral hemangioma invading the body and posterior arch of T-3 with posterior epidural extension. Laminectomy and vertebroplasty were performed after cesarean section, allowing neurological recovery. The second case involved a 35-year-old woman who presented with spontaneous fracture of T-7 at 36 weeks of gestation, revealing a vertebral hemangioma with no neurological deficit, but it was responsible for pain and local instability. Treatment consisted of postpartum posterior interbody fusion. With a clinical and radiological follow-up of 2 years, no complications and no modification of the hemangiomas were observed. A review of the literature reveals discordant management of these rare cases, which is why the treatment course must be decided by a multidisciplinary team as a function of fetal gestational age and maternal neurological features.

  3. Pulmonary cement embolism after pedicle screw vertebral stabilization

    Directory of Open Access Journals (Sweden)

    Massimo Tonolini

    2012-01-01

    Full Text Available Pulmonary arterial embolization of polymethylmethacrylate cement, most usually occurring after vertebroplasty or kyphoplasty, is very uncommon following vertebral stabilization procedures. Unenhanced CT scans viewed at lung window settings allow confident identification of cement emboli in the pulmonary circulation along with possible associate parenchymal changes, whereas hyperdense emboli may be less conspicuous on CT-angiographic studies with high-flow contrast medium injection. Although clinical manifestations are largely variable from asymptomatic cases to severe respiratory distress, most cases are treated with anticoagulation.

  4. Vertebrate phylogeny of hydrogen sulfide vasoactivity.

    Science.gov (United States)

    Dombkowski, Ryan A; Russell, Michael J; Schulman, Alexis A; Doellman, Meredith M; Olson, Kenneth R

    2005-01-01

    Hydrogen sulfide (H(2)S) is a recently identified endogenous vasodilator in mammals. In steelhead/rainbow trout (Oncorhynchus mykiss, Osteichthyes), H(2)S produces both dose-dependent dilation and a unique dose-dependent constriction. In this study, we examined H(2)S vasoactivity in all vertebrate classes to determine whether H(2)S is universally vasoactive and to identify phylogenetic and/or environmental trends. H(2)S was generated from NaHS and examined in unstimulated and precontracted systemic and, when applicable, pulmonary arteries (PA) from Pacific hagfish (Eptatretus stouti, Agnatha), sea lamprey (Petromyzon marinus, Agnatha), sandbar shark (Carcharhinus milberti, Chondrichthyes), marine toad (Bufo marinus, Amphibia), American alligator (Alligator mississippiensis, Reptilia), Pekin duck (Anas platyrhynchos domesticus, Aves), and white rat (Rattus rattus, Mammalia). In otherwise unstimulated vessels, NaHS produced 1) a dose-dependent relaxation in Pacific hagfish dorsal aorta; 2) a dose-dependent contraction in sea lamprey dorsal aorta, marine toad aorta, alligator aorta and PA, duck aorta, and rat thoracic aorta; 3) a threshold relaxation in shark ventral aorta, dorsal aorta, and afferent branchial artery; and 4) a multiphasic contraction-relaxation-contraction in the marine toad PA, duck PA, and rat PA. Precontraction of these vessels with another agonist did not affect the general pattern of NaHS vasoactivity with the exception of the rat aorta, where relaxation was now dominant. These results show that H(2)S is a phylogenetically ancient and versatile vasoregulatory molecule that appears to have been opportunistically engaged to suit both organ-specific and species-specific homeostatic requirements.

  5. Percutanous vertebroplasty for vertebral compression fracture in ...

    African Journals Online (AJOL)

    ; a report of two cases. ... Background: Osteoporotic vertebral fractures are common in the geriatric age group. ... Conclusion: Percutanous vertebroplasty offers effective, immediate and sustained pain relief in osteoporotic vertebral fractures.

  6. An invertebrate stomach's view on vertebrate ecology

    DEFF Research Database (Denmark)

    Calvignac-Spencer, Sébastien; Leendertz, Fabian H.; Gilbert, Tom

    2013-01-01

    Recent studies suggest that vertebrate genetic material ingested by invertebrates (iDNA) can be used to investigate vertebrate ecology. Given the ubiquity of invertebrates that feed on vertebrates across the globe, iDNA might qualify as a very powerful tool for 21st century population...

  7. Cilia Control Vascular Mural Cell Recruitment in Vertebrates

    Directory of Open Access Journals (Sweden)

    Xiaowen Chen

    2017-01-01

    Full Text Available Vascular mural cells (vMCs are essential components of the vertebrate vascular system, controlling blood vessel maturation and homeostasis. Discrete molecular mechanisms have been associated with vMC development and differentiation. The function of hemodynamic forces in controlling vMC recruitment is unclear. Using transgenic lines marking developing vMCs in zebrafish embryos, we find that vMCs are recruited by arterial-fated vessels and that the process is flow dependent. We take advantage of tissue-specific CRISPR gene targeting to demonstrate that hemodynamic-dependent Notch activation and the ensuing arterial genetic program is driven by endothelial primary cilia. We also identify zebrafish foxc1b as a cilia-dependent Notch-specific target that is required within endothelial cells to drive vMC recruitment. In summary, we have identified a hemodynamic-dependent mechanism in the developing vasculature that controls vMC recruitment.

  8. Proposal of anatomical terminology to call the arteries of the base of the encephalon in the monkey (Cebus paella L., 1766 Nomenclatura proposta para denominar as artérias da base do encéfalo do macaco-prego (Cebus apella L., 1766

    Directory of Open Access Journals (Sweden)

    Jussara Rocha Ferreira

    2001-05-01

    Full Text Available Arteries of the encephalon basis of 30 monkeys (Cebus paella were studied. Arteries were injected with colored latex, fixed in formaldehyde solution at 10% and dissected under magnifying lenses. Since the animals died from natural causes they had been previously used in other experiments. Human and veterinary anatomical terminology and literature were used as a reference for the determination of vessels studied in the primates. Arteries of the encephalon base represent division branches of three vascular pedicules: the right and left internal carotid arteries and the basilar system. Vessels in the basilar system of the animal were called vertebral arteries; anterior spinal artery; anterior and posterior cerebelar arteries; pontine arteries; satellite cerebelar arteries; caudal and cranial cerebelar arteries. The basilar artery bifurcates into two posterior cerebral arteries (100%. The caudal area of the encephalon’s arterial circuit is thus constituted. Linking between the vertebro-basilar and the carotid segments is done by the posterior communicating artery, that caudally anastomizes (100% with the posterior cerebral artery. The internal carotid artery gives origin to the posterior communicating artery. The right and left internal carotid artery (intracranial portion compounds the carotid system. The following vessels were identified: middle cerebral artery; anterior cerebral artery; interhemispheric artery; olfactory arteries. Results report that Cebus paella presents an arterial pattern of relative morphological stabilityEstudaram-se as artérias da base do encéfalo do Cebus apella em 30 animais, vindos a óbito por morte natural no Zoológico de São Paulo e coletados durante 10 anos. O material recebeu injeção de látex corado, fixado em formol a 10%, e foi dissecado sob lupa. Encontramos dificuldade e denominar estes vasos. As terminologias anatômicas humana e veterinária e a recuperação da literatura nos serviram de base para

  9. ORIGINAL ARTICLE ORIG MRI determination of the vertebral ...

    African Journals Online (AJOL)

    difference in the DS termination level, compared with the levels reported in various ... Using spinal MRI to establish the lower border of the CSI portal field will, however, benefit patients by ensuring adequate coverage of the entire neuroaxis as well as ... T2-weighted sagittal images were available, the relevant anatomy was.

  10. ORIGINAL ARTICLE ORIG MRI determination of the vertebral ...

    African Journals Online (AJOL)

    Knowledge of the approximate caudal termination of the dural sac (DS) is important, especially when placing the portal fields during lower craniospinal irradiation (CSI) and performing caudal anaesthesia. The purpose of this investigation was to determine the level of termination of the DS in relation to the spine in a group ...

  11. Zygotic Genome Activation in Vertebrates.

    Science.gov (United States)

    Jukam, David; Shariati, S Ali M; Skotheim, Jan M

    2017-08-21

    The first major developmental transition in vertebrate embryos is the maternal-to-zygotic transition (MZT) when maternal mRNAs are degraded and zygotic transcription begins. During the MZT, the embryo takes charge of gene expression to control cell differentiation and further development. This spectacular organismal transition requires nuclear reprogramming and the initiation of RNAPII at thousands of promoters. Zygotic genome activation (ZGA) is mechanistically coordinated with other embryonic events, including changes in the cell cycle, chromatin state, and nuclear-to-cytoplasmic component ratios. Here, we review progress in understanding vertebrate ZGA dynamics in frogs, fish, mice, and humans to explore differences and emphasize common features. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Bilateral variations of renal and testicular arteries

    Directory of Open Access Journals (Sweden)

    Gurses IA

    2009-05-01

    Full Text Available The variations of the arteries that develop from the mesonephric arteries – including renal, gonadal and suprarenal arteries – are common. Understanding the anatomy of the vascular variations of this region is essential for the clinicians to perform procedures such as renal transplantation, interventional radiologic procedures and renal vascular operations more safely and efficiently. In order to facilitate the clinical approaches, we present a male cadaver with bilateral double renal arteries accompanied with doubled right testicular arteries and a left testicular artery of high origin, and we discuss the surgical, radiologic and possible embryologic aspects.

  13. Vertebral development and amphibian evolution.

    Science.gov (United States)

    Carroll, R L; Kuntz, A; Albright, K

    1999-01-01

    Amphibians provide an unparalleled opportunity to integrate studies of development and evolution through the investigation of the fossil record of larval stages. The pattern of vertebral development in modern frogs strongly resembles that of Paleozoic labyrinthodonts in the great delay in the ossification of the vertebrae, with the centra forming much later than the neural arches. Slow ossification of the trunk vertebrae in frogs and the absence of ossification in the tail facilitate the rapid loss of the tail during metamorphosis, and may reflect retention of the pattern in their specific Paleozoic ancestors. Salamanders and caecilians ossify their centra at a much earlier stage than frogs, which resembles the condition in Paleozoic lepospondyls. The clearly distinct patterns and rates of vertebral development may indicate phylogenetic separation between the ultimate ancestors of frogs and those of salamanders and caecilians within the early radiation of ancestral tetrapods. This divergence may date from the Lower Carboniferous. Comparison with the molecular regulation of vertebral development described in modern mammals and birds suggests that the rapid chondrification of the centra in salamanders relative to that of frogs may result from the earlier migration of sclerotomal cells expressing Pax1 to the area surrounding the notochord.

  14. Evolution and differential expression of a vertebrate vitellogenin gene cluster

    Directory of Open Access Journals (Sweden)

    Kongshaug Heidi

    2009-01-01

    Full Text Available Abstract Background The multiplicity or loss of the vitellogenin (vtg gene family in vertebrates has been argued to have broad implications for the mode of reproduction (placental or non-placental, cleavage pattern (meroblastic or holoblastic and character of the egg (pelagic or benthic. Earlier proposals for the existence of three forms of vertebrate vtgs present conflicting models for their origin and subsequent duplication. Results By integrating phylogenetics of novel vtg transcripts from old and modern teleosts with syntenic analyses of all available genomic variants of non-metatherian vertebrates we identify the gene orthologies between the Sarcopterygii (tetrapod branch and Actinopterygii (fish branch. We argue that the vertebrate vtg gene cluster originated in proto-chromosome m, but that vtg genes have subsequently duplicated and rearranged following whole genome duplications. Sequencing of a novel fourth vtg transcript in labrid species, and the presence of duplicated paralogs in certain model organisms supports the notion that lineage-specific gene duplications frequently occur in teleosts. The data show that the vtg gene cluster is more conserved between acanthomorph teleosts and tetrapods, than in ostariophysan teleosts such as the zebrafish. The differential expression of the labrid vtg genes are further consistent with the notion that neofunctionalized Aa-type vtgs are important determinants of the pelagic or benthic character of the eggs in acanthomorph teleosts. Conclusion The vertebrate vtg gene cluster existed prior to the separation of Sarcopterygii from Actinopterygii >450 million years ago, a period associated with the second round of whole genome duplication. The presence of higher copy numbers in a more highly expressed subcluster is particularly prevalent in teleosts. The differential expression and latent neofunctionalization of vtg genes in acanthomorph teleosts is an adaptive feature associated with oocyte hydration

  15. Gonadotropin releasing hormone in the primitive vertebrate family Myxinidae: reproductive neuroanatomy and evolutionary aspects.

    Science.gov (United States)

    Sills, Eric Scott; Palermo, Gianpiero D

    2013-01-01

    The family Myxinidae embraces all hagfish species, and occupies an evolutionary niche intermediate between ancestral vertebrates and the gnathostomes (jawed vertebrates). Gonadotropin releasing hormone (GnRH) modulates neuroendocrine activity in vertebrates and works in the context of the hypothalamic-pituitary (H-P) axis. The appearance of this neuroendocrine axis marks one of the most crucial developmental achievements in vertebrate evolution, because it enabled further diversification in general growth, metabolism, osmoregulation and reproduction as jawed vertebrates evolved. GnRH studies in hagfish draw attention because such work may be considered as providing proxy data for similar investigations conducted upon long extinct species. Indeed, the fossil record reveals little anatomical difference between those hagfish living 300 million years ago and their modern descendants. Accordingly, the hagfish can offer important evolutionary lessons as they have some highly unusual characteristics not seen in any other vertebrate; they retain many representative features of an ancestral state from which all vertebrates originated. Indeed, because central control of reproduction is perhaps the most basic function of the vertebrate H-P axis, and given the importance of GnRH in this network, research on GnRH in hagfish can help elucidate the early evolution of the H-P system itself. Like all vertebrates, hagfish have a functional hypothalamic area and a pituitary gland, constituting a basic H-P axis. But what role does GnRH play in the reproductive system of this "living fossil"? How can understanding GnRH in hagfish help advance the knowledge of vertebrate neuroendocrinology? Here, information on neuroendocrine function and the role of GnRH specifically in this very basal vertebrate is reviewed.

  16. Imperfect Isolation: Factors and Filters Shaping Madagascar’s Extant Vertebrate Fauna

    Science.gov (United States)

    Samonds, Karen E.; Godfrey, Laurie R.; Ali, Jason R.; Goodman, Steven M.; Vences, Miguel; Sutherland, Michael R.; Irwin, Mitchell T.; Krause, David W.

    2013-01-01

    Analyses of phylogenetic topology and estimates of divergence timing have facilitated a reconstruction of Madagascar’s colonization events by vertebrate animals, but that information alone does not reveal the major factors shaping the island’s biogeographic history. Here, we examine profiles of Malagasy vertebrate clades through time within the context of the island’s paleogeographical evolution to determine how particular events influenced the arrival of the island’s extant groups. First we compare vertebrate profiles on Madagascar before and after selected events; then we compare tetrapod profiles on Madagascar to contemporary tetrapod compositions globally. We show that changes from the Mesozoic to the Cenozoic in the proportions of Madagascar’s tetrapod clades (particularly its increase in the representation of birds and mammals) are tied to changes in their relative proportions elsewhere on the globe. Differences in the representation of vertebrate classes from the Mesozoic to the Cenozoic reflect the effects of extinction (i.e., the non-random susceptibility of the different vertebrate clades to purported catastrophic global events 65 million years ago), and new evolutionary opportunities for a subset of vertebrates with the relatively high potential for transoceanic dispersal potential. In comparison, changes in vertebrate class representation during the Cenozoic are minor. Despite the fact that the island’s isolation has resulted in high vertebrate endemism and a unique and taxonomically imbalanced extant vertebrate assemblage (both hailed as testimony to its long isolation), that isolation was never complete. Indeed, Madagascar’s extant tetrapod fauna owes more to colonization during the Cenozoic than to earlier arrivals. Madagascar’s unusual vertebrate assemblage needs to be understood with reference to the basal character of clades originating prior to the K-T extinction, as well as to the differential transoceanic dispersal advantage of

  17. Reversible Isolated Accessory Nerve Palsy due to a Large Thrombosed Vertebral Aneurysm

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    Hisayasu Saito

    2013-08-01

    Full Text Available Objective: Isolated accessory nerve palsy due to intracranial disorders is uncommon because intracranial accessory nerve injury usually occurs in case of a skull base tumor or trauma, resulting in one of multiple cranial nerve palsies. We report a very rare case of isolated accessory nerve palsy due to a large thrombosed aneurysm of the intracranial vertebral artery. Full recovery was achieved after surgery. Case Report: A patient complaining of transient numbness in the right side was referred to our hospital. An MRI indicated a large thrombosed aneurysm of the right vertebral artery. The aneurysm severely compressed the medulla oblongata. First, the proximal vertebral artery (VA was clipped with an aneurysm clip to reduce the pressure inside the aneurysm. However, cerebral angiography revealed a partial recanalization of the right VA. The patient then underwent coil embolization of the right VA just proximal to the aneurysm clip. Subsequently, the right VA was completely obliterated. The patient was discharged without any neurological deficit. Two weeks later, however, she complained of right shoulder pain. Physical and neurological examinations demonstrated atrophy of the right trapezius and sternocleidomastoid muscle, leading to a deepening of the right supraclavicular fossa. The symptoms were considered to result from the right isolated accessory nerve palsy. Follow-up MRI showed that the VA aneurysm gradually decreased in size over a period of several months. At the same time, her symptoms disappeared completely. Conclusion: We should keep in mind that isolated accessory nerve palsy can be caused by a large or giant vertebral aneurysm.

  18. . ORIGINAL ARTICLES

    African Journals Online (AJOL)

    pathology, extent of disease on chest radiograph and/or CT of the lungs, HIV status, surgical procedures, and outcome. Outcome ~as considered successful if the .... hypervascular collaterals from the internal mammary arteries, subclavian artery branches, intercostal arteries and even aneurysms from the pulmonary arteries.

  19. Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Iscaife, Alexandre, E-mail: iscaifeboni@yahoo.com.br; Yoshinaga, Eduardo M., E-mail: dumuracca@ig.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil); Moreira, Airton Mota, E-mail: motamoreira@gmail.com [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2016-01-15

    PurposeTo compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia.MethodsWe prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL).ResultsAll groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (Q{sub max}), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and Q{sub max}. TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher Q{sub max} and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria.ConclusionsTURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.

  20. Comparative Studies of Vertebrate Platelet Glycoprotein 4 (CD36

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    Roger S. Holmes

    2012-09-01

    Full Text Available Platelet glycoprotein 4 (CD36 (or fatty acyl translocase [FAT], or scavenger receptor class B, member 3 [SCARB3] is an essential cell surface and skeletal muscle outer mitochondrial membrane glycoprotein involved in multiple functions in the body. CD36 serves as a ligand receptor of thrombospondin, long chain fatty acids, oxidized low density lipoproteins (LDLs and malaria-infected erythrocytes. CD36 also influences various diseases, including angiogenesis, thrombosis, atherosclerosis, malaria, diabetes, steatosis, dementia and obesity. Genetic deficiency of this protein results in significant changes in fatty acid and oxidized lipid uptake. Comparative CD36 amino acid sequences and structures and CD36 gene locations were examined using data from several vertebrate genome projects. Vertebrate CD36 sequences shared 53–100% identity as compared with 29–32% sequence identities with other CD36-like superfamily members, SCARB1 and SCARB2. At least eight vertebrate CD36 N-glycosylation sites were conserved which are required for membrane integration. Sequence alignments, key amino acid residues and predicted secondary structures were also studied. Three CD36 domains were identified including cytoplasmic, transmembrane and exoplasmic sequences. Conserved sequences included N- and C-terminal transmembrane glycines; and exoplasmic cysteine disulphide residues; TSP-1 and PE binding sites, Thr92 and His242, respectively; 17 conserved proline and 14 glycine residues, which may participate in forming CD36 ‘short loops’; and basic amino acid residues, and may contribute to fatty acid and thrombospondin binding. Vertebrate CD36 genes usually contained 12 coding exons. The human CD36 gene contained transcription factor binding sites (including PPARG and PPARA contributing to a high gene expression level (6.6 times average. Phylogenetic analyses examined the relationships and potential evolutionary origins of the vertebrate CD36 gene with vertebrate

  1. Presence of chromogranin-derived antimicrobial peptides in plasma during coronary artery bypass surgery and evidence of an immune origin of these peptides.

    Science.gov (United States)

    Tasiemski, Aurélie; Hammad, Hamida; Vandenbulcke, Franck; Breton, Christophe; Bilfinger, Thomas J; Pestel, Joel; Salzet, Michel

    2002-07-15

    Chromogranin A (CGA) and chromogranin B (CGB) are acidic proteins stored in secretory organelles of endocrine cells and neurons. In addition to their roles as helper proteins in the packaging of peptides, they may serve as prohormones to generate biologically active peptides such as vasostatin-1 and secretolytin. These molecules derived from CGA and CGB, respectively, possess antimicrobial properties. The present study demonstrates that plasmatic levels of both vasostatin-1 and secretolytin increase during surgery in patients undergoing cardiopulmonary bypass (CPB). Vasostatin-1 and secretolytin, initially present in plasma at low levels, are released just after skin incision. Consequently, they can be added to enkelytin, an antibacterial peptide derived from proenkephalin A, for the panoply of components acting as a first protective barrier against hypothetical invasion of pathogens, which may occur during surgery. CGA and CGB, more commonly viewed as markers for endocrine and neuronal cells, were also found to have an immune origin. RNA messengers coding for CGB were amplified by reverse transcription-polymerase chain reaction in human monocytes, and immunocytochemical analysis by confocal microscopy revealed the presence of CGA or CGB or both in monocytes and neutrophils. A combination of techniques including confocal microscopic analysis, mass spectrometry measurement, and antibacterial tests allowed for the identification of the positive role of interleukin 6 (IL-6) in the secretolytin release from monocytes in vitro. Because IL-6 release is known to be strongly enhanced during CPB, we suggest a possible relationship between IL-6 and the increased level of secretolytin in patients undergoing CPB.

  2. Allergenicity of vertebrate tropomyosins: Challenging an immunological dogma.

    Science.gov (United States)

    González-Fernández, J; Daschner, A; Cuéllar, C

    With the exception of tilapia tropomyosin, other anecdotic reports of tropomyosin recognition of vertebrate origin are generally not accompanied by clinical significance and a dogmatic idea is generally accepted about the inexistence of allergenicity of vertebrate tropomyosins, based mainly on sequence similarity evaluations with human tropomyosins. Recently, a specific work-up of a tropomyosin sensitised patient with seafood allergy, demonstrated that the IgE-recognition of tropomyosin from different fish species can be clinically relevant. We hypothesise that some vertebrate tropomyosins could be relevant allergens. The hypothesis is based on the molecular evolution of the proteins and it was tested by in silico methods. Fish, which are primitive vertebrates, could have tropomyosins similar to those of invertebrates. If the hypothesis is confirmed, tropomyosin should be included in different allergy diagnosis tools to improve the medical protocols and management of patients with digestive or cutaneous symptoms after fish intake. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  3. The molecular evolution of the vertebrate behavioural repertoire.

    Science.gov (United States)

    Grant, Seth G N

    2016-01-05

    How the sophisticated vertebrate behavioural repertoire evolved remains a major question in biology. The behavioural repertoire encompasses the set of individual behavioural components that an organism uses when adapting and responding to changes in its external world. Although unicellular organisms, invertebrates and vertebrates share simple reflex responses, the fundamental mechanisms that resulted in the complexity and sophistication that is characteristic of vertebrate behaviours have only recently been examined. A series of behavioural genetic experiments in mice and humans support a theory that posited the importance of synapse proteome expansion in generating complexity in the behavioural repertoire. Genome duplication events, approximately 550 Ma, produced expansion in the synapse proteome that resulted in increased complexity in synapse signalling mechanisms that regulate components of the behavioural repertoire. The experiments demonstrate the importance to behaviour of the gene duplication events, the diversification of paralogues and sequence constraint. They also confirm the significance of comparative proteomic and genomic studies that identified the molecular origins of synapses in unicellular eukaryotes and the vertebrate expansion in proteome complexity. These molecular mechanisms have general importance for understanding the repertoire of behaviours in different species and for human behavioural disorders arising from synapse gene mutations. © 2015 The Authors.

  4. Synchrotron-aided reconstruction of the conodont feeding apparatus and implications for the mouth of the first vertebrates.

    Science.gov (United States)

    Goudemand, Nicolas; Orchard, Michael J; Urdy, Séverine; Bucher, Hugo; Tafforeau, Paul

    2011-05-24

    The origin of jaws remains largely an enigma that is best addressed by studying fossil and living jawless vertebrates. Conodonts were eel-shaped jawless animals, whose vertebrate affinity is still disputed. The geometrical analysis of exceptional three-dimensionally preserved clusters of oro-pharyngeal elements of the Early Triassic Novispathodus, imaged using propagation phase-contrast X-ray synchrotron microtomography, suggests the presence of a pulley-shaped lingual cartilage similar to that of extant cyclostomes within the feeding apparatus of euconodonts ("true" conodonts). This would lend strong support to their interpretation as vertebrates and demonstrates that the presence of such cartilage is a plesiomorphic condition of crown vertebrates.

  5. An Aberrant Artery Arising From Common Hepatic Artery

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    Surekha D. Jadhav

    2015-01-01

    Full Text Available Common hepatic artery is the branch of celiac trunk which is chief artery of the foregut. Branches of celiac trunk supply the gastrointestinal tract and its associated glands which are derived from foregut. Anatomy and variations of hepatic arterial system have become increasingly important due to increasing number of laparoscopic procedures, oncologic surgical interventions, and organ transplant cases. This case report describes a rare anatomical variation of an aberrant artery arising from common hepatic artery before the origin of gastroduodenal artery and proper hepatic artery.The aberrant artery traversed inferiorly and behind the body of the pancreas which divided into a right and left branches. The right branch ran behind the neck of the pancreas and it ended after giving few branches to head and body of pancreas. However, the left branch gave off branches to the proximal part of the jejunum. The presence of a branch arising directly from the common hepatic artery supplying the pancreas and jejunum is uncommon. Knowledge of such a rare variation is important not only for surgeons but also interventional radiologists and those studying anatomy

  6. Osteomielitis vertebral piógena Pyogenic vertebral osteomyelitis

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    Pedro P. Perrotti

    2009-10-01

    Full Text Available La osteomielitis vertebral piógena (OVP es una localización poco frecuente (2-7% Se confirma con el aislamiento de un microorganismo de una vértebra, disco intervertebral, absceso epidural o paravertebral. Se describe una serie de casos por la infrecuente presentación de esta enfermedad, que puede ser consulta inicial en los servicios de clínica médica y por su sintomatología inespecífica que supone una dificultad diagnóstica. Tanto la columna lumbar como la dorsal fueron los sitios más afectados. El dolor dorsolumbar y la paraparesia fueron los síntomas más frecuentes de presentación. En ocho pacientes se aislaron Staphylococcus aureus, en uno Escherichia coli y en el restante Haemophylus sp. Se observó leucocitosis sólo en tres pacientes, y en dos velocidad de sedimentación globular mayor de 100 mm/h. Los diez pacientes presentaron imágenes características de osteomielitis vertebral piógena en la resonancia nuclear magnética. Dentro de las complicaciones, los abscesos paravertebrales y epidurales fueron los más frecuentes (en cinco enfermos. Además, un paciente presentó empiema pleural. De los diez pacientes de esta serie, siete recibieron inicialmente tratamiento médico empírico y luego específico para el germen aislado. En los restantes el tratamiento fue guiado de acuerdo al antibiograma. A dos enfermos fue necesario realizarles laminectomía descompresiva por compromiso de partes blandas y a otros dos estabilización quirúrgica por inestabilidad espinal, observándose buena evolución en todos los casos. Esta serie demuestra que, ante un paciente con dolor dorsolumbar y síntomas neurológicos se deberá tener en cuenta esta entidad para evitar un retraso en el tratamiento.Pyogenic osteomyelitis seldom affects the spine (2-7%. It is diagnosed by the isolation of a bacterial agent in the vertebral body, the intervertebral disks or from paravertebral or epidural abscesses. We report a retrospective study of ten

  7. The vertebral nerve: A comprehensive review of its form and function.

    Science.gov (United States)

    Johal, Jaspreet; BelElary, Sharath S; Lax, Elizabeth A; Maharaja, Gopi K; Oskouian, Rod J; Loukas, Marios; Tubbs, R Shane

    2017-07-01

    The literature is littered with variable and scant reports of the vertebral nerve. The present paper reviews the literature regarding this nervous structure of the neck and attempts to clarify a number of issues surrounding its form, function, and implications of surgical manipulation. The nerve may arise from the stellate ganglion or the ansa subclavia, amongst a number of other structures. Additionally, the terminal insertion of the vertebral nerve varies in the reported literature, with authors observing various terminations. Animal models of the vertebral nerve have limited value, as variations between species and with species have been observed. This review also indicates that contradictory evidence exists regarding the clinical implications of vertebral nerve damage. Although irritation may result in ocular disturbance, hearing loss, headaches, and dizziness, a high degree of incongruity exists around whether or not any clinical findings will actually be observed. Based on our review of the available literature and recent cadaveric research, it appears it may be more logical to classify the vertebral nerve as a variable ramus communicans that connects the stellate or inferior cervical ganglia to the lower cervical spinal nerves and not a structure that ascends entirely with the vertebral artery to enter the cranium. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. El enigma de la hipertensión arterial pulmonar de origen indeterminado The enigma of primary pulmonary hypertension of undetermined origin

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    Aquiles Roncoroni

    2002-08-01

    nosological characteristics of this condition. Some authors only accept as primary pulmonary hypertension those patients without any other possible cause. They even exclude those with familiar pulmonary hypertension since its genetical etiology is now well established. It is more generally accepted that the very low incidence of pulmonary hypertension in conditions such as anorexigen use, portal hypertension or others, suggest the coincidence of a permissive genotype, susceptible phenotype (endothelial dysfunction and a triggering factor. In such a way, pulmonary hypertension may be associated with apparently dissimilar conditions. B The current interpretation of histologic lesions and their relationship with recent histochemical and immunological findings. The previously proposed hypothesis that some lesions are final and inactive results of prolonged hypertension is difficult to uphold since they were found only months after the clinical beginning of the disease. Moreover cells at the center of the plexiform lesion show histochemical activity patterns. It is also proposed that the anatomically inapparent endothelial dysfunction may be the original event. C Proposed causal mechanisms such as down-regulation or even absence of K+ voltage channels of the pulmonary vascular smooth muscle cell. This finding would include primary pulmonary hypertension among the simultaneous "channel diseases". The data that justify the possible influence of serotonin plasma levels are also commented.

  9. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Too, Chow Wei, E-mail: spyder55@gmail.com; Koch, Guillaume, E-mail: guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juliengarnon@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital, Interventional Radiology Department (France)

    2017-03-15

    Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

  10. Evolutionary Specialization of Tactile Perception in Vertebrates

    Science.gov (United States)

    Schneider, Eve R.

    2016-01-01

    Evolution has endowed vertebrates with the remarkable tactile ability to explore the world through the perception of physical force. Yet the sense of touch remains one of the least well understood senses at the cellular and molecular level. Vertebrates specializing in tactile perception can highlight general principles of mechanotransduction. Here, we review cellular and molecular adaptations that underlie the sense of touch in typical and acutely mechanosensitive vertebrates. PMID:27053733

  11. Evolutionary Specialization of Tactile Perception in Vertebrates

    OpenAIRE

    Schneider, Eve R.; Gracheva, Elena O.; Bagriantsev, Slav N.

    2016-01-01

    Evolution has endowed vertebrates with the remarkable tactile ability to explore the world through the perception of physical force. Yet the sense of touch remains one of the least well understood senses at the cellular and molecular level. Vertebrates specializing in tactile perception can highlight general principles of mechanotransduction. Here, we review cellular and molecular adaptations that underlie the sense of touch in typical and acutely mechanosensitive vertebrates.

  12. Vertebral wedging characteristic changes in scoliotic spines.

    Science.gov (United States)

    Parent, Stefan; Labelle, Hubert; Skalli, Wafa; de Guise, Jacques

    2004-10-15

    A morphometric analysis of vertebral wedging in vertebrae from scoliotic specimens. To quantify the vertebral body changes in 30 anatomic specimens affected by a scoliotic deformity. Only a few studies have evaluated the exact changes occurring at the level of the vertebral body in scoliotic spines. Most are observational studies of rare scoliotic specimens presenting major curvatures. The orientation of vertebral wedging is important for the planning of corrective surgery, performing vertebral osteotomy, and the evaluation of possible growth modulation. Thirty scoliotic specimens with curves presenting various degrees of severity were studied using a three-dimensional digitizing protocol developed to create a precise three-dimensional reconstruction of the vertebrae. Every scoliotic specimen was then matched with a normal specimen, and comparisons were made on the vertebral body parameters both for thoracic and lumbar vertebrae. Analysis of variance and t test calculations were performed to identify significant differences with P = 0.05. A total of 471 vertebrae from scoliotic spines and 510 vertebrae from normal specimens were measured. Vertebral wedging increased progressively towards the apex of the curve and was maximal at the apex. Vertebral wedging was more prominent in the frontal plane, and there was minimal wedging in the sagittal plane. Vertebral heights were significantly different at T3 and T4 for the upper adjacent curve and at T6-T8 for a typical right thoracic curve, with smaller heights located on the concavity of the curve. No changes were observed on the convexity of the curve. Vertebral wedging is an essential component of the scoliotic deformity. The present study provides critical information for corrective surgery and vertebral osteotomy, as vertebral wedging occurs primarily in the frontal plane. Accurate knowledge of this deformity should also provide new insight into corrective surgical strategies aiming at growth modulation and more

  13. The evolution of the terrestrial vertebrates: environmental and physiological considerations.

    Science.gov (United States)

    Bray, A A

    1985-04-02

    Physiological evidence has long been used to suggest that the gnathostomous vertebrates (those possessing jaws) were primitively fresh water. The same was also the case for the Osteichthyes (bony fish) and the Tetrapoda (Amphibia, Reptilia, Aves, Mammalia). However, the geological evidence favours a marine origin for the vertebrates as a whole, and, for the gnathostomes and the osteichthyans in particular. Some of the earliest amphibian remains may be associated with tidally influenced sediments. Furthermore, during the early part of the Devonian, fresh water chemistry may well have been different from that of today, lessening the divide between marine and non-marine environments. Urea formation via the ornithine cycle, and urea retention in the body fluids, are useful adaptations for terrestrial life. They prevent excessive water loss associated with the elimination of nitrogenous waste. These abilities may have been primitive for the gnathostomes, and were developed in the marine environment to reduce osmotic dehydration. In the aqueous medium, gaseous exchange is effected by the gills. These organs are, on the whole, useless in air. For vertebrates, air-breathing is effected by an inflatable sac, with moist linings, and an internal location. Some form of air-breathing sac was primitive for the osteichthyans, and may have been primitive for the gnathostomes. Again, this adaptation for terrestrial life developed in response to conditions experienced in the marine, aquatic environment. A new model of tetrapod evolution is proposed in the light of the basic marine origin and character of the ancestors of the tetrapods.

  14. A New Vertebral Body Replacement Strategy Using Expandable Polymeric Cages.

    Science.gov (United States)

    Liu, Xifeng; Paulsen, Alex; Giambini, Hugo; Guo, Ji; Miller, A Lee; Lin, Po-Chun; Yaszemski, Michael J; Lu, Lichun

    2017-03-01

    We have developed a novel polymeric expandable cage that can be delivered via a posterior-only surgical approach for the treatment of noncontained vertebral defects. This approach is less invasive than an anterior-only or combined approach and much more cost-effective than currently used expandable metal cages. The polymeric expandable cage is composed of oligo poly(ethylene glycol) fumarate (OPF), a hydrogel that has been previously shown to have excellent nerve and bone tissue biocompatibility. OPF hydrogel cages can expand to twice their original diameter and length within a surgical time frame following hydration. Modulation of parameters such as polymeric network crosslink density or the introduction of charge to the network allowed for precise expansion kinetics. To meet specific requirements due to size variations in patient vertebral bodies, we fabricated a series of molds with varied diameters and explored the expansion kinetics of the OPF cages. Results showed a stable expansion ratio of approximately twofold to the original size within 20 min, regardless of the absolute value of the cage size. Following implantation of a dried OPF cage into a noncontained vertebral defect and its in situ expansion with normal saline, other augmentation biomaterials, such as poly(propylene fumarate) (PPF), can be injected to the lumen of the OPF cage and allowed to crosslink in situ. The OPF/PPF composite scaffold can provide the necessary rigidity and stability to the augmented spine.

  15. Homology of insect corpora allata and vertebrate adenohypophysis?

    Science.gov (United States)

    Wirmer, Andrea; Bradler, Sven; Heinrich, Ralf

    2012-09-01

    Animal species of various phyla possess neuroendocrine glands whose hormonal products regulate developmental and physiological mechanisms and directly impact behavior. Two examples, the corpora allata of insects and the vertebrate adenohypophysis have previously been regarded as analogous tissues that evolved independently from diffuse epidermal nerve nets of early metazoans. More recent developmental and functional studies accumulated evidence suggesting that the bilaterian nervous systems including its modern parts (e.g. pallium or cortex and mushroom bodies) and its neuroendocrine appendages (that are considered to be more ancient structures) possess a single evolutionary origin. The corpora allata of insects and the vertebrate adenohypophysis share a number of characteristics in respect of morphology, control of hormone release by RFamides, metabolites produced by closely related cytochrome P450 enzymes and gene expression during embryonic development. This review incorporates latest findings into an extensive description of similarities between insect corpora allata and vertebrate adenohypophysis that should encourage further studies about the onto- and phylogenetic origin of these neuroendocrine glands. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. A COMPARATIVE STUDY OF EFFICACY AND TOLERABILITY OF GENERIC AND ORIGINAL LOW-DOSE BISOPROLOL/HYDROCHLOROTHIAZIDE COMBINATION IN PATIENTS WITH ARTERIAL HYPERTENSION OF 1-2 DEGREES. RESULTS OF CLINICAL RANDOMIZED CROSSOVER STUDY

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-09-01

    Full Text Available Aim. To study the clinical equivalence of the two low-dose combined drugs on the base of generic and original bisoprolol and hydrochlorothiazide (HCTZ: BISANGIL® (Ozon, Russia and LODOZ® (NYCOMED, Merck KGaA, Germany in patients with arterial hypertension (HT of 1-2 degrees.Material and methods. Patients with HT of 1-2 degrees (n=30; 11 men and 19 women; aged 62.7±10.7 years were included in open crossover randomized trial. Duration of the study for each patient was 18 weeks: two 6-week courses of active treatment with each drug and two 2-week washout periods prior to each treatment course. The sequence of treatment courses was determined by randomization. Increase in bisoprolol dose and/or amlodipine addition occurred when effect was not sufficient. Therapy effectiveness (office blood pressure (BP, heart rate and safety was monitored at visits.Results. BP reduction after 6 weeks of therapy was -21.6±11.1/10.4±11.3 mm Hg in LODOZ® group and -22.9±9.7/11.7±13.5 mm Hg in BISANGIL® group (p<0.0001 for both, intergroup differences were insignificant. Target BP after 6 weeks of therapy was achieved in 26 (87% and 28 (93% patients, respectively.Conclusion. The therapeutic equivalence of the studied fixed combinations of bisoprolol/HCTZ was demonstrated in treatment of patients with HT of 1-2 degrees.

  17. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... Health Topics / Coronary Artery Bypass Grafting Coronary Artery Bypass Grafting What Is Coronary artery bypass grafting (CABG) ... multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of the ...

  18. Ghrelin receptors in non-mammalian vertebrates

    Directory of Open Access Journals (Sweden)

    Hiroyuki eKaiya

    2013-07-01

    Full Text Available The growth hormone secretagogue-receptor (GHS-R was discovered in humans and pigs in 1996. The endogenous ligand, ghrelin, was discovered three years later, in 1999, and our understanding of the physiological significance of the ghrelin system in vertebrates has grown steadily since then. Although the ghrelin system in non-mammalian vertebrates is a subject of great interest, protein sequence data for the receptor in non-mammalian vertebrates has been limited until recently, and related biological information has not been well organized. In this review, we summarize current information related to the ghrelin receptor in non-mammalian vertebrates.

  19. Spontaneous vertebral dissection: Clinical, conventional angiographic, CT, and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Provenzale, J.M.; Morgenlander, J.C. [Duke Univ. Medical Center, Durham, NC (United States); Gress, D. [Univ. of California, San Francisco, CA (United States)

    1996-03-01

    The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontratimatic precipitating event ({open_quotes}trivial trauma{close_quotes}) and presence of possible risk factors such as hypertension. All patients under-went conventional angiography, 13 either CT or MRI (II both CT and MRI), and 3 MRA. Conventional arteriograrris were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation, CT examinations for the presence of infarction or subarachnoid hemorrhage, MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one.

  20. Primary Ewing's sarcoma of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, Ch2-290 200 First Street, SW, Rochester, 55905, MN (United States); Unni, K.Krishnan [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States); Dekutoski, Mark B. [Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States)

    2004-09-01

    To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three cases were mixed lytic and sclerotic (6%) and one sclerotic. In the nonsacral spine, the majority of lesions (12/20) involved the posterior elements with extension into the vertebral body. Five cases were centered in the vertebral body with extension into the posterior elements. Two cases were limited to the posterior elements, and one case solely involved the vertebral body. Ala was the most frequently affected site in the sacrum (18/26). Spinal canal invasion was frequent (91%). Detailed clinical information was available in 53 patients. Duration of symptoms ranged from 1 to 30 (mean 7) months. Local pain was the first symptom and seen in all cases. Neurological deficits were present in 21 (40%) cases. All patients received radiation in various dosages; 70% additionally received chemotherapy. Twenty-five patients had surgery, and two patients received bone marrow transplantation. Forty-five patients had follow-up; the five-year disease-free survival probability is 0

  1. Morphometry and Variability of the Brain Arterial Circle in Chinchilla (Chinchilla laniger, Molina).

    Science.gov (United States)

    Kuchinka, Jacek

    2017-08-01

    Arterial circles of brains from 70 adult chinchillas were filled with synthetic latex. The arterial circle of the brain is formed as the result of vertebral arteries being merged into the basilar artery. Caudally, both vertebral arteries gave rise to the ventral spinal artery. The ventral spinal artery splits into tiny cerebellar vessels, the pontine and cochlear branches. Distally, the basilar artery ramified into two terminal branches that formed the arterial circle of brain, rostrally open in most cases (75%). The observed variability of the arterial circle of brain of chinchillas pertained to all elements of that circle. The greatest variability within the vessels of the circle of Willis in chinchillas was observed in 22 cases (31.4%) of internal ophthalmic arteries. In chinchillas, a trend toward slight variability within the arteries comprising the arterial circle of the brain was observed in 44 animals. This accounted for 62.8% of all cases. Only in three cases was the arterial circle of brain clearly symmetrical. At the same time, 23 animals (32.8%) revealed features of significant vascular variability within the brain base region. These consisted of disturbed geometry of the entire arterial circle, different levels of ramifications into individual arteries, as well as the number and diameter of arteries. No internal carotid arteries were observed in chinchillas apart from one atypical case in which the carotid artery extended unilaterally into the basilar artery. These investigations indicate on the significant variability of arterial circle in rodents. Anat Rec, 300:1472-1480, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  2. Coronary Arteries

    Science.gov (United States)

    ... animations for grades K-6. The Coronary Arteries Coronary Circulation The heart muscle, like every other organ or ... the heart by its own vascular system, called coronary circulation. The aorta (the main blood supplier to the ...

  3. Cervical artery dissection following a turbulent flight.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2012-01-31

    BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

  4. Third-generation percutaneous vertebral augmentation systems.

    Science.gov (United States)

    Vanni, Daniele; Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo

    2016-03-01

    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater than 30% loss of height. Currently, this type of treatment is not feasible. Herein we review the characteristics and methods of operation of three of the most common percutaneous vertebral augmentation systems (PVAS) for the treatment of OVF: Vertebral Body Stenting(®) (VBS), OsseoFix(®) and Spine Jack(®). VBS is a titanium device accompanied by a hydraulic (as opposed to mechanical) working system which allows a partial and not immediate possibility to control the opening of the device. On the other hand, OsseoFix(®) and Spine Jack(®) are accompanied by a mechanical working system which allows a progressive and controlled reduction of the vertebral fracture. Another important aspect to consider is the vertebral body height recovery. OsseoFix(®) has an indirect mechanism of action: the compaction of the trabecular bone causes an increase in the vertebral body height. Unlike the Vertebral Body Stenting(®) and Spine Jack(®), the OsseoFix(®) has no direct lift mechanism. Therefore, for these characteristics and for the force that this device is able to provide. In our opinion, Spine Jack(®) is the only device also suitable for the treatment OVF, traumatic fracture (recent, old or inveterate) and primary or secondary bone tumors.

  5. Goldenhar Syndrome Associated with Extensive Arterial Malformations.

    Science.gov (United States)

    Modica, Renee Frances; Barbeau, L Daphna Yasova; Co-Vu, Jennifer; Beegle, Richard D; Williams, Charles A

    2015-01-01

    Goldenhar Syndrome is characterized by craniofacial, ocular and vertebral defects secondary to abnormal development of the 1st and 2nd branchial arches and vertebrae. Other findings include cardiac and vascular abnormalities. Though these associations are known, the specific anomalies are not well defined. We present a 7-month-old infant with intermittent respiratory distress that did not improve with respiratory interventions. Echocardiogram suggested a double aortic arch. Cardiac CT angiogram confirmed a right arch and aberrant, stenotic left subclavian artery, dilation of the main pulmonary artery, and agenesis of the left thyroid lobe. Repeat echocardiograms were concerning for severely dilated coronary arteries. Given dilation, a rheumatologic workup ensued, only identifying few weakly positive autoantibodies. Further imaging demonstrated narrowing of the aorta below the renal arteries and extending into the common iliac arteries and proximal femoral arteries. Given a physical exam devoid of rheumatologic findings, only weakly positive autoantibodies, normal inflammatory markers, and presence of the coronary artery dilation, the peripheral artery narrowings were not thought to be vasculitic. This case illustrates the need to identify definitive anomalies related to Goldenhar Syndrome. Although this infant's presentation is rare, recognition of specific vascular findings will help differentiate Goldenhar Syndrome from other disease processes.

  6. Goldenhar Syndrome Associated with Extensive Arterial Malformations

    Directory of Open Access Journals (Sweden)

    Renee Frances Modica

    2015-01-01

    Full Text Available Goldenhar Syndrome is characterized by craniofacial, ocular and vertebral defects secondary to abnormal development of the 1st and 2nd branchial arches and vertebrae. Other findings include cardiac and vascular abnormalities. Though these associations are known, the specific anomalies are not well defined. We present a 7-month-old infant with intermittent respiratory distress that did not improve with respiratory interventions. Echocardiogram suggested a double aortic arch. Cardiac CT angiogram confirmed a right arch and aberrant, stenotic left subclavian artery, dilation of the main pulmonary artery, and agenesis of the left thyroid lobe. Repeat echocardiograms were concerning for severely dilated coronary arteries. Given dilation, a rheumatologic workup ensued, only identifying few weakly positive autoantibodies. Further imaging demonstrated narrowing of the aorta below the renal arteries and extending into the common iliac arteries and proximal femoral arteries. Given a physical exam devoid of rheumatologic findings, only weakly positive autoantibodies, normal inflammatory markers, and presence of the coronary artery dilation, the peripheral artery narrowings were not thought to be vasculitic. This case illustrates the need to identify definitive anomalies related to Goldenhar Syndrome. Although this infant’s presentation is rare, recognition of specific vascular findings will help differentiate Goldenhar Syndrome from other disease processes.

  7. Rarefaction and blood pressure in systemic and pulmonary arteries

    OpenAIRE

    Mette S Olufsen; N. A. Hill; VAUGHAN, GARETH D. A.; Sainsbury, Christopher; Johnson, Martin

    2012-01-01

    The effects of vascular rarefaction (the loss of small arteries) on the circulation of blood are studied using a multiscale mathematical model that can predict blood flow and pressure in the systemic and pulmonary arteries. We augmented a model originally developed for the systemic arteries (Olufsen et al. 1998, 1999, 2000, 2004) to (a) predict flow and pressure in the pulmonary arteries, and (b) predict pressure propagation along the small arteries in the vascular beds. The systemic and pulm...

  8. Original Research Original Research

    African Journals Online (AJOL)

    RAGHAVENDRA

    Technol. Arts Res. J., April-June 2015, 4(2): 164-180. 168. Table 2: Actinomycetes with potent antimicrobial activity and their origin (soil). Isolates. Origin (soil). PO-01, PO-02. Mandagadde. PO-03, PO-04. Mahishi. PO-05. Bejjavalli. PO-06. Kudumallige. PO-07, PO-08. Maaluru. PO-09, PO-10 Thirthahalli. PO-11. Kaimara.

  9. Blunt vertebral vascular injury in trauma patients: ATLS®recommendations and review of current evidence.

    Science.gov (United States)

    Shafafy, Roozbeh; Suresh, Sukrit; Afolayan, John O; Vaccaro, Alexander R; Panchmatia, Jaykar R

    2017-06-01

    Blunt cerebrovascular injury (BCVI) encompasses two distinct clinical entities: traumatic carotid artery injury (TCAI) and traumatic vertebral artery injury (TVAI). The latter is the focus of our review. These are potentially devastating injuries which pose a diagnostic challenge in the acute trauma setting. There is still debate regarding the optimal screening criteria, diagnostic imaging modality and treatment methods. In 2012 the American College of Surgeons proposed criteria for investigating patients with suspected TVAI and subsequent treatment methods, caveated with the statement that evidence is limited and still evolving. Here we review the historical evidence and recent literature relating to these recommendations.

  10. Routine needle biopsy during vertebral augmentation procedures. Is it necessary?

    OpenAIRE

    Pneumaticos, Spiros G; Sofia N. Chatziioannou; Savvidou, Christiana; Pilichou, Anastasia; Rontogianni, Dimitra; Korres, Dimitrios S

    2010-01-01

    Vertebral augmentation procedures are currently widely performed to treat vertebral compression fractures. The purpose of this study was to determine the frequency of underlying previously unrecognized etiology in a consecutive series of patients undergoing kyphoplasty to treat vertebral compression fractures. A prospective histological evaluation of vertebral body biopsy specimens from presumed osteoporotic vertebral compression fractures were performed in order to identify aforementioned ca...

  11. Facultative parthenogenesis discovered in wild vertebrates

    Science.gov (United States)

    Booth, Warren; Smith, Charles F.; Eskridge, Pamela H.; Hoss, Shannon K.; Mendelson, Joseph R.; Schuett, Gordon W.

    2012-01-01

    Facultative parthenogenesis (FP)—asexual reproduction by bisexual species—has been documented in a variety of multi-cellular organisms but only recently in snakes, varanid lizards, birds and sharks. Unlike the approximately 80 taxa of unisexual reptiles, amphibians and fishes that exist in nature, FP has yet to be documented in the wild. Based on captive documentation, it appears that FP is widespread in squamate reptiles (snakes, lizards and amphisbaenians), and its occurrence in nature seems inevitable, yet the task of detecting FP in wild individuals has been deemed formidable. Here we show, using microsatellite DNA genotyping and litter characteristics, the first cases of FP in wild-collected pregnant females and their offspring of two closely related species of North American pitviper snakes—the copperhead (Agkistrodon contortrix) and cottonmouth (Agkistrodon piscivorus). Our findings support the view that non-hybrid origins of parthenogenesis, such as FP, are more common in squamates than previously thought. With this confirmation, FP can no longer be viewed as a rare curiosity outside the mainstream of vertebrate evolution. Future research on FP in squamate reptiles related to proximate control of induction, reproductive competence of parthenogens and population genetics modelling is warranted. PMID:22977071

  12. The role of transposable elements in the evolution of non-mammalian vertebrates and invertebrates

    Science.gov (United States)

    2010-01-01

    Background Transposable elements (TEs) have played an important role in the diversification and enrichment of mammalian transcriptomes through various mechanisms such as exonization and intronization (the birth of new exons/introns from previously intronic/exonic sequences, respectively), and insertion into first and last exons. However, no extensive analysis has compared the effects of TEs on the transcriptomes of mammals, non-mammalian vertebrates and invertebrates. Results We analyzed the influence of TEs on the transcriptomes of five species, three invertebrates and two non-mammalian vertebrates. Compared to previously analyzed mammals, there were lower levels of TE introduction into introns, significantly lower numbers of exonizations originating from TEs and a lower percentage of TE insertion within the first and last exons. Although the transcriptomes of vertebrates exhibit significant levels of exonization of TEs, only anecdotal cases were found in invertebrates. In vertebrates, as in mammals, the exonized TEs are mostly alternatively spliced, indicating that selective pressure maintains the original mRNA product generated from such genes. Conclusions Exonization of TEs is widespread in mammals, less so in non-mammalian vertebrates, and very low in invertebrates. We assume that the exonization process depends on the length of introns. Vertebrates, unlike invertebrates, are characterized by long introns and short internal exons. Our results suggest that there is a direct link between the length of introns and exonization of TEs and that this process became more prevalent following the appearance of mammals. PMID:20525173

  13. High-altitude adaptations in vertebrate hemoglobins

    DEFF Research Database (Denmark)

    Weber, Roy E.

    2007-01-01

    Vertebrates at high altitude are subjected to hypoxic conditions that challenge aerobic metabolism. O2 transport from the respiratory surfaces to tissues requires matching between the O2 loading and unloading tensions and theO2-affinity of blood, which is an integrated function of hemoglobin......, birds and ectothermic vertebrates at high altitude....

  14. The MHC molecules of nonmammalian vertebrates

    DEFF Research Database (Denmark)

    Kaufman, J; Skjoedt, K; Salomonsen, J

    1990-01-01

    to develop. There is no molecular evidence yet to decide whether vertebrate immune systems (and particularly the MHC molecules) are evolutionarily related to invertebrate allorecognition systems, and the functional evidence can be interpreted either way. Even among the vertebrates, there is great...

  15. [Spondylosis: diseases of the vertebral column].

    Science.gov (United States)

    Pérez, Amador Schüller

    2008-01-01

    Frequent and transcendent diseases for the difficulties of his diagnosis and treatment. The components of the vertebral column, vertebral bodies, discs and unvertebral joints, spondylosis ligaments must be considered to be a functional Unit. The Patology of each one of their parts concerns or reverberates in others.

  16. BK Channels in the Vertebrate Inner Ear

    NARCIS (Netherlands)

    Pyott, S. J.; Duncan, R. K.; Contet, C

    2016-01-01

    The perception of complex acoustic stimuli begins with the deconstruction of sound into its frequency components. This spectral processing occurs first and foremost in the inner ear. In vertebrates, two very different strategies of frequency analysis have evolved. In nonmammalian vertebrates, the

  17. Vertebral architecture in the earliest stem tetrapods.

    Science.gov (United States)

    Pierce, Stephanie E; Ahlberg, Per E; Hutchinson, John R; Molnar, Julia L; Sanchez, Sophie; Tafforeau, Paul; Clack, Jennifer A

    2013-02-14

    The construction of the vertebral column has been used as a key anatomical character in defining and diagnosing early tetrapod groups. Rhachitomous vertebrae--in which there is a dorsally placed neural arch and spine, an anteroventrally placed intercentrum and paired, posterodorsally placed pleurocentra--have long been considered the ancestral morphology for tetrapods. Nonetheless, very little is known about vertebral anatomy in the earliest stem tetrapods, because most specimens remain trapped in surrounding matrix, obscuring important anatomical features. Here we describe the three-dimensional vertebral architecture of the Late Devonian stem tetrapod Ichthyostega using propagation phase-contrast X-ray synchrotron microtomography. Our scans reveal a diverse array of new morphological, and associated developmental and functional, characteristics, including a possible posterior-to-anterior vertebral ossification sequence and the first evolutionary appearance of ossified sternal elements. One of the most intriguing features relates to the positional relationships between the vertebral elements, with the pleurocentra being unexpectedly sutured or fused to the intercentra that directly succeed them, indicating a 'reverse' rhachitomous design. Comparison of Ichthyostega with two other stem tetrapods, Acanthostega and Pederpes, shows that reverse rhachitomous vertebrae may be the ancestral condition for limbed vertebrates. This study fundamentally revises our current understanding of vertebral column evolution in the earliest tetrapods and raises questions about the presumed vertebral architecture of tetrapodomorph fish and later, more crownward, tetrapods.

  18. Arterial stiffness

    Directory of Open Access Journals (Sweden)

    Ursula Quinn

    2012-09-01

    Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

  19. Left subclavian artery revascularization as part of thoracic stent grafting.

    Science.gov (United States)

    Saouti, Nabil; Hindori, Vikash; Morshuis, William J; Heijmen, Robin H

    2015-01-01

    Intentional covering of the left subclavian artery (LSA) as part of thoracic endovascular aortic repair (TEVAR) can cause (posterior) strokes or left arm malperfusion. LSA revascularization can be done as prophylaxis against, or as treatment of, these complications. We report our experience with the surgical technique, indications and the results of LSA revascularization. Between 2000 and 2013, 51 patients of 444 patients who were treated by TEVAR, had LSA revascularization. All elective patients had a preoperative work-up with magnetic resonance angiography to evaluate the circle of Willis. In all, surgical access was through a left supraclavicular incision only. The majority (90%) had prophylactic LSA revascularization because of incomplete circle of Willis and or dominant left vertebral artery (LVA) (n=29), patent left internal mammary artery (n=1), prevention spinal cord ischaemia (SCI) (n=2), prevention left arm ischaemia due to small LVA (n=2) and LVA origin in arch (n=1). Fourteen percent had secondary revascularization, either immediate because of malperfusion of the left arm (n=2) or late after TEVAR because of persisting left arm claudication (n=5). In 12 patients, the following early complications were observed: re-exploration for bleeding, n=1; left recurrent nerve paralysis, n=2; left phrenic nerve paralysis, n=1; left sympathetic chain neuropraxia, resulting in Horner's syndrome, n=3; Chyle duct lesions, resulting in persistent Chyle leakage, n=3. Neither strokes nor SCI was observed. One patient experienced occlusion of the bypass at 6 months. The present study shows that the procedure of LSA revascularization as part of TEVAR is safe with low morbidity consisting of mainly (transient) nerve palsy. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. COMPARATIVE STUDY OF NEW DRUG OF LONG ACTING METOPROLOL TARTRATE - EGILOK RETARD AND ORIGINAL DRUG OF METOPROLOL SUCCINATE – BETALOC ZOK IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    J. V. Lukina

    2015-12-01

    Full Text Available Aim. To study efficiency and safety of new drug of long acting metoprolol tartrate, “Egilok retard” (ER in patients with mild to moderate arterial hypertension (AH in comparison with the original drug of metoprolol succinat, “Betaloc ZOK” (BZ, possibility of reaching target blood pressure (BP level with treatment with each drug.Material and methods. 30 patients (11 men and 19 women with mild to moderate AH took part in randomized, open, cross over study. Previous antihypertensive treatment had been canceled for all the patients 10-14 days before the study started. Each patient by turns was treated during 6 weeks with ER and BZ 50-100 mg daily. After cancellation of the previous antihypertensive therapy, BZ and ER were prescribed (according to the randomization table in dose 50 mg daily. Drugs were taken once per day. 29 patients completed therapy with the first drug of randomization, 25 patients – with the second. After 2 weeks efficiency of treatment was assessed by target BP level achievement (< 140/90 mmHg. If efficiency of beta-adrenoblocker (BB was not sufficient, the dose of the drug was doubled to 100 mg daily, if target level was reached – the dose remained unchanged. Treatment with the settled dose was held within next 4 weeks. After 6-week treatment with the first randomized drug antihypertensive therapy was canceled for 10-14 days depending on the BB dose. At each visit office BP and heart rate were assessed, EKG was registered. Side-effects were registered according to the self-control diary, questionnaire results, examination and EKG data.Results. After 6-week treatment with ER and BZ average level of systolic BP reduced by 15,7 and 15,2 mmHg, of diastolic BP – by 8,0 and 4,5 mmHg, heart rate – by 4,1 and 4,3 beat/min respectively. Differences between antihypertensive and heart rate lowering effect of the studied drugs were not significant. Target BP level with treatment with both drugs was reached in approximately

  1. COMPARATIVE STUDY OF NEW DRUG OF LONG ACTING METOPROLOL TARTRATE - EGILOK RETARD AND ORIGINAL DRUG OF METOPROLOL SUCCINATE – BETALOC ZOK IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    J. V. Lukina

    2005-01-01

    Full Text Available Aim. To study efficiency and safety of new drug of long acting metoprolol tartrate, “Egilok retard” (ER in patients with mild to moderate arterial hypertension (AH in comparison with the original drug of metoprolol succinat, “Betaloc ZOK” (BZ, possibility of reaching target blood pressure (BP level with treatment with each drug.Material and methods. 30 patients (11 men and 19 women with mild to moderate AH took part in randomized, open, cross over study. Previous antihypertensive treatment had been canceled for all the patients 10-14 days before the study started. Each patient by turns was treated during 6 weeks with ER and BZ 50-100 mg daily. After cancellation of the previous antihypertensive therapy, BZ and ER were prescribed (according to the randomization table in dose 50 mg daily. Drugs were taken once per day. 29 patients completed therapy with the first drug of randomization, 25 patients – with the second. After 2 weeks efficiency of treatment was assessed by target BP level achievement (< 140/90 mmHg. If efficiency of beta-adrenoblocker (BB was not sufficient, the dose of the drug was doubled to 100 mg daily, if target level was reached – the dose remained unchanged. Treatment with the settled dose was held within next 4 weeks. After 6-week treatment with the first randomized drug antihypertensive therapy was canceled for 10-14 days depending on the BB dose. At each visit office BP and heart rate were assessed, EKG was registered. Side-effects were registered according to the self-control diary, questionnaire results, examination and EKG data.Results. After 6-week treatment with ER and BZ average level of systolic BP reduced by 15,7 and 15,2 mmHg, of diastolic BP – by 8,0 and 4,5 mmHg, heart rate – by 4,1 and 4,3 beat/min respectively. Differences between antihypertensive and heart rate lowering effect of the studied drugs were not significant. Target BP level with treatment with both drugs was reached in approximately

  2. Mitotic chromosome condensation in vertebrates

    Energy Technology Data Exchange (ETDEWEB)

    Vagnarelli, Paola, E-mail: P.Vagnarelli@ed.ac.uk

    2012-07-15

    Work from several laboratories over the past 10-15 years has revealed that, within the interphase nucleus, chromosomes are organized into spatially distinct territories [T. Cremer, C. Cremer, Chromosome territories, nuclear architecture and gene regulation in mammalian cells, Nat. Rev. Genet. 2 (2001) 292-301 and T. Cremer, M. Cremer, S. Dietzel, S. Muller, I. Solovei, S. Fakan, Chromosome territories-a functional nuclear landscape, Curr. Opin. Cell Biol. 18 (2006) 307-316]. The overall compaction level and intranuclear location varies as a function of gene density for both entire chromosomes [J.A. Croft, J.M. Bridger, S. Boyle, P. Perry, P. Teague,W.A. Bickmore, Differences in the localization and morphology of chromosomes in the human nucleus, J. Cell Biol. 145 (1999) 1119-1131] and specific chromosomal regions [N.L. Mahy, P.E. Perry, S. Gilchrist, R.A. Baldock, W.A. Bickmore, Spatial organization of active and inactive genes and noncoding DNA within chromosome territories, J. Cell Biol. 157 (2002) 579-589] (Fig. 1A, A'). In prophase, when cyclin B activity reaches a high threshold, chromosome condensation occurs followed by Nuclear Envelope Breakdown (NEB) [1]. At this point vertebrate chromosomes appear as compact structures harboring an attachment point for the spindle microtubules physically recognizable as a primary constriction where the two sister chromatids are held together. The transition from an unshaped interphase chromosome to the highly structured mitotic chromosome (compare Figs. 1A and B) has fascinated researchers for several decades now; however a definite picture of how this process is achieved and regulated is not yet in our hands and it will require more investigation to comprehend the complete process. From a biochemical point of view a vertebrate mitotic chromosomes is composed of DNA, histone proteins (60%) and non-histone proteins (40%) [6]. I will discuss below what is known to date on the contribution of these two different classes

  3. Vertebrate Reservoirs of Arboviruses: Myth, Synonym of Amplifier, or Reality?

    Directory of Open Access Journals (Sweden)

    Goro Kuno

    2017-07-01

    Full Text Available The rapid succession of the pandemic of arbovirus diseases, such as dengue, West Nile fever, chikungunya, and Zika fever, has intensified research on these and other arbovirus diseases worldwide. Investigating the unique mode of vector-borne transmission requires a clear understanding of the roles of vertebrates. One major obstacle to this understanding is the ambiguity of the arbovirus definition originally established by the World Health Organization. The paucity of pertinent information on arbovirus transmission at the time contributed to the notion that vertebrates played the role of reservoir in the arbovirus transmission cycle. Because this notion is a salient feature of the arbovirus definition, it is important to reexamine its validity. This review addresses controversial issues concerning vertebrate reservoirs and their role in arbovirus persistence in nature, examines the genesis of the problem from a historical perspective, discusses various unresolved issues from multiple points of view, assesses the present status of the notion in light of current knowledge, and provides options for a solution to resolve the issue.

  4. Vertebrate Reservoirs of Arboviruses: Myth, Synonym of Amplifier, or Reality?

    Science.gov (United States)

    Kuno, Goro; Mackenzie, John S; Junglen, Sandra; Hubálek, Zdeněk; Plyusnin, Alexander; Gubler, Duane J

    2017-07-13

    The rapid succession of the pandemic of arbovirus diseases, such as dengue, West Nile fever, chikungunya, and Zika fever, has intensified research on these and other arbovirus diseases worldwide. Investigating the unique mode of vector-borne transmission requires a clear understanding of the roles of vertebrates. One major obstacle to this understanding is the ambiguity of the arbovirus definition originally established by the World Health Organization. The paucity of pertinent information on arbovirus transmission at the time contributed to the notion that vertebrates played the role of reservoir in the arbovirus transmission cycle. Because this notion is a salient feature of the arbovirus definition, it is important to reexamine its validity. This review addresses controversial issues concerning vertebrate reservoirs and their role in arbovirus persistence in nature, examines the genesis of the problem from a historical perspective, discusses various unresolved issues from multiple points of view, assesses the present status of the notion in light of current knowledge, and provides options for a solution to resolve the issue.

  5. Vertebral pain in helicopter pilots

    Science.gov (United States)

    Auffret, R.; Delahaye, R. P.; Metges, P. J.; VICENS

    1980-01-01

    Pathological forms of spinal pain engendered by piloting helicopters were clinically studied. Lumbalgia and pathology of the dorsal and cervical spine are discussed along with their clinical and radiological signs and origins.

  6. Mechanical Recanalization of Cerebral Artery Embolic Occlusion Using a Self-Expanding Stent: Experimental Analysis in Canine Model

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo; Kim, Snag Joon; Lee, Deok Hee; Suh, Dae Chul [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2011-07-15

    To evaluate the feasibility of a self-expanding stent for acute embolic occlusion, and recanalization mechanism by histologic examination. Five mongrel dogs were used as study subjects. Each vertebral artery was occluded, and a self-expanding stent was used for recanalization. We evaluated the technical success rate for the placement of the stent to the targeted vessel, the recanalization rate, and residual stenosis. We obtained two specimens of the stented vertebral arteries for histologic evaluation. One dog died of an unknown cause during the induction of anesthesia. In two dogs, only one side of the vertebral artery was used, whereas both vertebral arteries were used in the remaining dogs. A total of six vertebral arteries were successfully occluded. The technical success rate for stenting without complication was 66.7%. The immediate recanalization rate after stenting was 100%. The residual stenosis was 35.6 {+-} 18.6%. On microscopic examination, the stent concentrically displaced the clot and the clot was captured between the stent mesh and arterial wall. Self-expanding stents were effective in revascularizing the cerebrovascular embolic occlusion. The self-expanding stent seemed to achieve recanalization by pushing the clot to the arterial wall and capturing the clot between the stent mesh and arterial wall.

  7. The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature Origem da artéria frênica inferior: estudo em 32 cadáveres da Índia do Sul com revisão da literatura

    Directory of Open Access Journals (Sweden)

    Thejodhar Pulakunta

    2007-09-01

    Full Text Available BACKGROUND: Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature. OBJECTIVE: Most anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA. For that reason, the origin of the IPA has been studied and the available literature has been reviewed. METHODS: Thirty-two human adult cadavers preserved in formalin obtained from the departments of Anatomy, Kasturba Medical College, Manipal and Mangalore were dissected and the origin of the IPA was studied. RESULTS: The IPA had its usual origin from the abdominal aorta in 28 cases but in the remaining four cases, two were arising from the celiac trunk, one from the left gastric artery and one from the right renal artery. CONCLUSION: The IPA usually originates from the aorta or celiac artery, and less frequently from the renal, hepatic or left gastric arteries. The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery. Literature on the IPA origin and clinical implications of variation in its origin have been reviewed in this article.CONTEXTO: Considerando a escassez de informações atualmente disponíveis sobre artérias frênicas inferiores, umestudo mais definitivo nos pareceu apropriado e necessário, tanto por suas potenciais aplicações clínicas quanto para fornecer dados adicionais à literatura anatômica contemporânea. OBJETIVO: A maioria dos livros-texto de anatomia oferece muito poucas informações referentes à anatomia e distribuição da artéria frênica inferior (AFI. Por este motivo, a origem da AFI foi investigada e a literatura disponível foi revisada. MÉTODOS: Trinta e dois cadáveres humanos adultos

  8. Arteriosclerotic femoral artery aneurysms. A short review

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    True arteriosclerotic aneurysms of the femoral artery are rare but they are dangerous lesions that may thrombose, embolise or rupture. They are often bilateral and frequently the patient has other aneurysms in the abdominal aortic or popliteal artery. True femoral aneurysms were originally...... classified by Cutler and Darling in 1973 as type 1 and type 2 according to their relationship to the common femoral bifurcation. Case reports of isolated superficial and profunda femoral artery aneurysms have been published, but these are exceedingly rare although isolated aneurysms of the profunda femoris...... artery may be more common in Denmark. True femoral artery aneurysms are attributed to weakening of the arterial wall due to atherosclerosis. True femoral artery aneurysms are relatively rare and are found in elderly smoking men. Aortic aneurysms are approximately 10 times more common. Distal embolization...

  9. Organizational heterogeneity of vertebrate genomes.

    Directory of Open Access Journals (Sweden)

    Svetlana Frenkel

    Full Text Available Genomes of higher eukaryotes are mosaics of segments with various structural, functional, and evolutionary properties. The availability of whole-genome sequences allows the investigation of their structure as "texts" using different statistical and computational methods. One such method, referred to as Compositional Spectra (CS analysis, is based on scoring the occurrences of fixed-length oligonucleotides (k-mers in the target DNA sequence. CS analysis allows generating species- or region-specific characteristics of the genome, regardless of their length and the presence of coding DNA. In this study, we consider the heterogeneity of vertebrate genomes as a joint effect of regional variation in sequence organization superimposed on the differences in nucleotide composition. We estimated compositional and organizational heterogeneity of genome and chromosome sequences separately and found that both heterogeneity types vary widely among genomes as well as among chromosomes in all investigated taxonomic groups. The high correspondence of heterogeneity scores obtained on three genome fractions, coding, repetitive, and the remaining part of the noncoding DNA (the genome dark matter--GDM allows the assumption that CS-heterogeneity may have functional relevance to genome regulation. Of special interest for such interpretation is the fact that natural GDM sequences display the highest deviation from the corresponding reshuffled sequences.

  10. Melatonin Receptor Genes in Vertebrates

    Directory of Open Access Journals (Sweden)

    Hua Dong Yin

    2013-05-01

    Full Text Available Melatonin receptors are members of the G protein-coupled receptor (GPCR family. Three genes for melatonin receptors have been cloned. The MT1 (or Mel1a or MTNR1A and MT2 (or Mel1b or MTNR1B receptor subtypes are present in humans and other mammals, while an additional melatonin receptor subtype, Mel1c (or MTNR1C, has been identified in fish, amphibians and birds. Another melatonin related orphan receptor, GPR50, which does not bind melatonin, is found exclusively in mammals. The hormone melatonin is secreted primarily by the pineal gland, with highest levels occurring during the dark period of a circadian cycle. This hormone acts systemically in numerous organs. In the brain, it is involved in the regulation of various neural and endocrine processes, and it readjusts the circadian pacemaker, the suprachiasmatic nucleus. This article reviews recent studies of gene organization, expression, evolution and mutations of melatonin receptor genes of vertebrates. Gene polymorphisms reveal that numerous mutations are associated with diseases and disorders. The phylogenetic analysis of receptor genes indicates that GPR50 is an outgroup to all other melatonin receptor sequences. GPR50 may have separated from a melatonin receptor ancestor before the split between MTNR1C and the MTNR1A/B ancestor.

  11. Molecular Synapomorphies Resolve Evolutionary Relationships of Extant Jawed Vertebrates

    National Research Council Canada - National Science Library

    Byrappa Venkatesh; Mark V. Erdmann; Sydney Brenner

    2001-01-01

    .... We identified 13 derived shared molecular markers (synapomorphies) that define clades in the vertebrate lineage and used them to resolve the phylogenetic relationships of extant jawed vertebrates...

  12. Pulmonary Embolism with Vertebral Augmentation Procedures

    Directory of Open Access Journals (Sweden)

    Swetha Bopparaju

    2013-01-01

    Full Text Available With the prevalence of an aging American population on the rise, osteoporotic vertebral fractures are becoming a common occurrence, resulting in an increase in vertebral augmentation procedures and associated complications such as cement leakage, vertebral compressions, and pulmonary embolism. We describe a patient who presented with respiratory distress three years following kyphoplasty of the lumbar vertebra. Computed tomography (CT angiogram of the chest confirmed the presence of polymethylmethacrylate (PMMA cement in the lung fields and pulmonary vessels. We conducted a systematic review of the published literature identifying effective management strategies for the treatment of vertebroplasty-associated pulmonary embolism.

  13. Epidemiology of acute vertebral osteomyelitis in Denmark

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Wagn, P; Bengtsson, J

    1998-01-01

    We studied the epidemiology of acute, non-tuberculous, hematogenous vertebral osteomyelitis in Denmark during 1978-1982. 137 patients fulfilled the criteria for acute vertebral osteomyelitis. The incidence was 5/mill/year. There were no cases in the age group 20-29 years. The highest incidence......-1993, the relative number of reported patients with vertebral osteomyelitis had increased in the age group 20-49 years, compared to 1978-1982, but the incidence was highest in the group aged 60-79 years....

  14. The vertebral biomechanic previous and after kyphoplasty.

    Science.gov (United States)

    Pesce, V; Piazzolla, Andrea; Moretti, L; Carlucci, S; Parato, C; Maxy, P; Moretti, B

    2013-10-01

    The biomechanical understanding of increasing anterior column load with progressing kyphosis leading to subsequent vertebral compression fracture (VCF) established the basic rationale for kyphoplasty. The lumbar spine can support an effort of 500 kg in the axis of the vertebral body, and a bending moment of 20 Nm in flexion. Consequently, if this effort is forward deviated of only 10 cm, the acceptable effort will be reduced to 20 kg so it is important to restore the vertebral anterior wall after a VCF: the authors describe the biomechanical modifications in the spine after kyphoplasty.

  15. The arteries of brain base in species of Bovini tribe.

    Science.gov (United States)

    Zdun, Maciej; Frąckowiak, Hieronim; Kiełtyka-Kurc, Agata; Kowalczyk, Karolina; Nabzdyk, Maria; Timm, Anita

    2013-11-01

    Studies were conducted on 78 preparations of head and brain arteries in four species of Bos genus, that is in domestic cattle (N = 59), including 22 foetuses (CRL 36.5-78.5 cm), in banteng (Bos javanicus, N = 3), yak (Bos mutus f. grunniens, N = 2), American bison (Bison bison, N = 4), and European bison (Bison bonasus, N = 10). The comparative analysis permitted to demonstrate a similar pattern of brain base arteries in the studied animals. In the studied species, blood vessels of the arterial circle of the brain were found to form by bifurcation of intracranial segments of inner carotid arteries, which protruded from the paired rostral epidural rete mirabile. In Bovidae arterial circle of the brain was supplied with blood mainly by maxillary artery through the blood vessels of the paired rostral epidural rete mirabile. The unpaired caudal epidural rete mirabile was participating in blood supply to the arterial circle of the brain from vertebral and occipital arteries. It manifested character of a taxonomic trait for species of Bos and Bison genera. Basilar artery in all the examined animals manifested a variable diameter, with preliminary portion markedly narrowed, which prevented its participation in blood supply to the arterial circle of the brain. The results and taxonomic position of the species made the authors to suggest a hypothesis that a similar arterial pattern on the brain base might be present also in other species, not included in this analysis. Copyright © 2013 Wiley Periodicals, Inc.

  16. Original Research Original Research

    African Journals Online (AJOL)

    RAGHAVENDRA

    in a sustainable way. Therefore, the objective of th was to assess poultry production practice productivity of indigenous and exotic chicken in th area. Original ... systems. Method of Data Collection. The data was collected from the four RKs purposively selected from each agro-ecology, 15 households who owned flock of ...

  17. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... but also to the worsening of the disease. Obstructive peripheral arterial disease most commonly develops in the arteries of the legs, including the two branches of the aorta (iliac arteries), main arteries of the thighs (femoral arteries), of ... arterial disease may also develop in the part ...

  18. Demographic aspects in cervical vertebral bodies' size and shape (C3-C7): a skeletal study.

    Science.gov (United States)

    Ezra, David; Masharawi, Youssef; Salame, Khalil; Slon, Viviane; Alperovitch-Najenson, Deborah; Hershkovitz, Israel

    2017-01-01

    This cross-sectional study was conducted on the skeletal remains of individuals of known sex, age, and ethnic origin. The vertebral bodies of levels C3-C7 were measured and analyzed. Whereas many studies were performed on the size and shape of the vertebral bodies in the thoracic and lumbar spines, few have focused on the cervical vertebral bodies. Thus, there is insufficient data in the literature on the anatomy of the cervical spine, especially based on large study populations. To establish a large database on cervical vertebral bodies' size and shape and analyze their association with demographic parameters. The population studied was composed of 277 individuals, adult males and females of African American (AA) and European American (EA) origin. The skeletal remains are housed at the Hamman-Todd Osteological collection (Cleveland Museum of Natural History, Cleveland, OH). A 3-D digitizer was used to measure the size and shape of the C3-C7 vertebral bodies. Descriptive statistics were carried out for all measurements. t Test and one-way analysis of variance were performed to assess differences in vertebral bodies' size and shape between different demographical groups (by age, sex, and ethnicity). The vertebral bodies and foramina are significantly wider, more elongated, and higher in males compared to females. AA females and males manifest significantly greater vertebral bodies (width and length) in the upper and midcervical region (vertebrae C3-C5) than EA females and males. Nevertheless, the heights of the C3 and C4 vertebral bodies are significantly smaller among the AA population, regardless of sex. The vertebral foramina's width does not differ significantly between the two ethnic groups, independent of sex, whereas they tend to be elongated in the EA group (significant for C3, C5, C7). For most vertebrae, no significant differences were found in the superior facets' length between AA and EA males and females. Cervical vertebral bodies become wider and more

  19. Delayed vertebral diagnosed L4 pincer vertebral fracture, L2-L3 ruptured vertebral lumbar disc hernia, L5 vertebral wedge fracture - Case report

    Directory of Open Access Journals (Sweden)

    Balasa D

    2016-08-01

    Full Text Available An association between delayed ruptured lumbar disc hernia, L5 vertebral wedge fracture and posttraumaticL4 pincer vertebral fracture (A2.3-AO clasification at different levels is a very rare entity. We present the case of a 55 years old male who falled down from a bicycle. 2 months later because of intense and permanent vertebral lumbar and radicular L2 and L3 pain (Visual Scal Autologus of Pain7-8/10 the patient came to the hospital. He was diagnosed with pincer vertebral L4 fracture (A2.3-AO clasification and L2-L3 right ruptured lumbar disc hernia in lateral reces. The patient was operated (L2-L3 right fenestration, and resection of lumbar disc hernia, bilateral stabilisation, L3-L4-L5 with titan screws and postero-lateral bone graft L4 bilateral harvested from iliac crest.

  20. Vertebral Fractures After Discontinuation of Denosumab

    DEFF Research Database (Denmark)

    Cummings, Steven R; Ferrari, Serge; Eastell, Richard

    2018-01-01

    Denosumab reduces bone resorption and vertebral and nonvertebral fracture risk. Denosumab discontinuation increases bone turnover markers 3 months after a scheduled dose is omitted, reaching above-baseline levels by 6 months, and decreases bone mineral density (BMD) to baseline levels by 12 months....... We analyzed the risk of new or worsening vertebral fractures, especially multiple vertebral fractures, in participants who discontinued denosumab during the FREEDOM study or its Extension. Participants received ≥2 doses of denosumab or placebo Q6M, discontinued treatment, and stayed in the study ≥7...... months after the last dose. Of 1001 participants who discontinued denosumab during FREEDOM or Extension, the vertebral fracture rate increased from 1.2 per 100 participant-years during the on-treatment period to 7.1, similar to participants who received and then discontinued placebo (n = 470; 8.5 per 100...

  1. Interconnections between the Ears in Nonmammalian Vertebrates

    DEFF Research Database (Denmark)

    Feng, Albert S.; Christensen-Dalsgaard, J.

    2010-01-01

    Many of the nonmammalian vertebrates (anurans, lizards, crocodiles, and some bird species) have large, continuous air spaces connecting the middle ears and acoustically coupling the eardrums. Acoustical coupling leads to strongly enhanced directionality of the ear at frequencies where diffraction...

  2. Innate immunity in vertebrates: an overview.

    Science.gov (United States)

    Riera Romo, Mario; Pérez-Martínez, Dayana; Castillo Ferrer, Camila

    2016-06-01

    Innate immunity is a semi-specific and widely distributed form of immunity, which represents the first line of defence against pathogens. This type of immunity is critical to maintain homeostasis and prevent microbe invasion, eliminating a great variety of pathogens and contributing with the activation of the adaptive immune response. The components of innate immunity include physical and chemical barriers, humoral and cell-mediated components, which are present in all jawed vertebrates. The understanding of innate defence mechanisms in non-mammalian vertebrates is the key to comprehend the general picture of vertebrate innate immunity and its evolutionary history. This is also essential for the identification of new molecules with applications in immunopharmacology and immunotherapy. In this review, we describe and discuss the main elements of vertebrate innate immunity, presenting core findings in this field and identifying areas that need further investigation. © 2016 John Wiley & Sons Ltd.

  3. Recombination drives vertebrate genome contraction.

    Science.gov (United States)

    Nam, Kiwoong; Ellegren, Hans

    2012-01-01

    Selective and/or neutral processes may govern variation in DNA content and, ultimately, genome size. The observation in several organisms of a negative correlation between recombination rate and intron size could be compatible with a neutral model in which recombination is mutagenic for length changes. We used whole-genome data on small insertions and deletions within transposable elements from chicken and zebra finch to demonstrate clear links between recombination rate and a number of attributes of reduced DNA content. Recombination rate was negatively correlated with the length of introns, transposable elements, and intergenic spacer and with the rate of short insertions. Importantly, it was positively correlated with gene density, the rate of short deletions, the deletion bias, and the net change in sequence length. All these observations point at a pattern of more condensed genome structure in regions of high recombination. Based on the observed rates of small insertions and deletions and assuming that these rates are representative for the whole genome, we estimate that the genome of the most recent common ancestor of birds and lizards has lost nearly 20% of its DNA content up until the present. Expansion of transposable elements can counteract the effect of deletions in an equilibrium mutation model; however, since the activity of transposable elements has been low in the avian lineage, the deletion bias is likely to have had a significant effect on genome size evolution in dinosaurs and birds, contributing to the maintenance of a small genome. We also demonstrate that most of the observed correlations between recombination rate and genome contraction parameters are seen in the human genome, including for segregating indel polymorphisms. Our data are compatible with a neutral model in which recombination drives vertebrate genome size evolution and gives no direct support for a role of natural selection in this process.