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Venous acces

Kosei Takagi, Takahito Yagi, Takehiro Tanaka, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Toshiyoshi Fujiwara
BACKGROUND: Although ectopic pancreatic tissue is common in the upper gastrointestinal tract, the incidence of ectopic pancreatic tissue in the jejunum is low, and malignant transformation in ectopic pancreatic tissue is rare. Furthermore, pancreatic-type acinar cell carcinoma (ACC) developing in the jejunum and ACC accompanied by tumor thrombus are extremely rare. CASE PRESENTATION: A 78-year-old-woman presented with melena. Abdominal computed tomography images and endoscopic examination revealed a submucosal jejunal mass with tumor thrombus extending into a jejunal vein...
June 29, 2017: BMC Surgery
Tae Yon Sung, Yun Mi Choi, Won Gu Kim, Yu Mi Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim, Dong Eun Song
The aim of this study is to describe rare variants of adrenocortical carcinoma (ACC) and to compare the prognosis with that of conventional ACC. We retrospectively reviewed 8 cases of myxoid variant, 1 sarcomatoid variant, and 14 cases of conventional ACC, who underwent surgical resection at the Asan Medical Center between 1996 and 2014. An analysis of the clinicopathological characteristics, including the Weiss score, Ki-67 labeling index, and reticulin framework assessment is presented. The mean age of patients with myxoid/sarcomatoid ACC was 45 years; 4 out of 9 patients were women...
May 2017: Journal of Korean Medical Science
Guoxi Xie, Hanwei Chen, Xueping He, Jianke Liang, Wei Deng, Zhuonan He, Yufeng Ye, Qi Yang, Xiaoming Bi, Xin Liu, Debiao Li, Zhaoyang Fan
BACKGROUND: Deep vein thrombosis (DVT) is a common but elusive illness that can result in long-term disability or death. Accurate detection of thrombosis and assessment of its size and distribution are critical for treatment decision-making. In the present study, we sought to develop and evaluate a cardiovascular magnetic resonance (CMR) black-blood thrombus imaging (BTI) technique, based on delay alternating with nutation for tailored excitation black-blood preparation and variable flip angle turbo-spin-echo readout, for the diagnosis of non-acute DVT...
January 18, 2017: Journal of Cardiovascular Magnetic Resonance
Nadeem Shaida, Andrew N Priest, T C See, Andrew P Winterbottom, Martin J Graves, David J Lomas
PURPOSE: To evaluate the diagnostic performance of velocity- and acceleration-sensitized noncontrast-enhanced magnetic resonance angiography (NCE-MRA) of the infrageniculate arteries using contrast-enhanced MRA (CE-MRA) as a reference standard. MATERIALS AND METHODS: Twenty-four patients with symptoms of peripheral arterial disease were recruited. Each patient's infrageniculate arterial tree was examined using a velocity-dependent flow-sensitized dephasing (VEL-FSD) technique, an acceleration-dependent (ACC-FSD) technique, and our conventional CE-MRA technique performed at 1...
November 30, 2016: Journal of Magnetic Resonance Imaging: JMRI
Qingbing Wang, Xiaolin Wang, Rongfang Guo, Guoping Li
Pancreatic acinar cell carcinoma (ACC) is a rare tumor that is difficult to diagnose preoperatively. The aim of this study was to evaluate and describe the computed tomography (CT) features of ACC and compare the results with pancreatic ductal adenocarcinoma (DAC) for improving preoperative diagnosis. The control group consisted of 34 patients with DAC collected from the pathology electronic database. The CT imaging from nine patients with pathologically confirmed ACC was retrospectively reviewed. Two radiologists independently assessed the tumor location, size, texture, and enhancement patterns...
2016: OncoTargets and Therapy
Sebastian Allgäuer
The cannulation of a central vein is a standard acces to the vascular system of critically ill patients. It can be used for administration of medication and parenteral nutrition, haemodynamic monitoring as well as hemodialsis via Shaldon catheter.The technique of implantation of a central venous catheter is described step by step in this article. Moreover, advantages and disadvantages of the different techniques and puncture sites as well as indications and contraindications are critically discussed regarding the most recent literature...
March 2016: Deutsche Medizinische Wochenschrift
Mohammadtaghi Rajabi Mashhadi, Reza Bagheri, Abbas Abdollahi, Mohammad Javad Ghamari, Soudabeh Shahidsales, Maryam Salehi, Reza Shahkaram, Mohamad Reza Majidi, Shima Sheibani
INTRODUCTION: Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR). MATERIALS AND METHODS: This randomized clinical trial was carried out between 2009 and 2011. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of 50 patients receiving standard chemoradiotherapy (Group A) and then undergoing surgery, and the second group consisted of 50 patients undergoing surgery only (Group B)...
July 2015: Iranian Journal of Otorhinolaryngology
Mohsen Ayati, Jafar Shahbazi, Ali Tehranchi, Elnaz Ayati, Yousef Rezaei
Adrenocortical carcinoma (ACC) is a rare aggressive tumor. Renal vein and inferior vena cava (IVC) thrombi have been found as uncommon presentations of ACC; however, the implementation of comprehensive therapy has remained controversial in such cases. We report a case of a 46-year-old woman with a large ACC associated with the invasion of tumor to IVC confirmed by imaging and immunohistochemistry examinations. The patient was treated successfully using aggressive surgery, including adrenalectomy and thrombectomy adjunct to an adrenocorticolytic agent...
July 2015: International Surgery
S Hussain, E Panteliou, D M Berney, R Carpenter, M Matson, A Sahdev, M Bell, E O'Sullivan, W M Drake
UNLABELLED: We describe a young male patient with longstanding hypertension, who was diagnosed with primary hyperaldosteronism and treated by an attempted retroperitoneoscopic total unilateral adrenalectomy for a left-sided presumed aldosterone-secreting adenoma. Imaging had shown an unremarkable focal adrenal lesion with normal contralateral adrenal morphology, and histology of the resected specimen showed no adverse features. Post-operatively, his blood pressure and serum aldosterone levels fell to the normal range, but 9 months later, his hypertension recurred, primary aldosteronism was again confirmed and he was referred to our centre...
2015: Endocrinology, Diabetes & Metabolism Case Reports
R S Metcalfe, F Koumanov, J S Ruffino, K A Stokes, G D Holman, D Thompson, N B J Vollaard
PURPOSE: We have previously shown that 6 weeks of reduced-exertion high-intensity interval training (REHIT) improves VO2max in sedentary men and women and insulin sensitivity in men. Here, we present two studies examining the acute physiological and molecular responses to REHIT. METHODS: In Study 1, five men and six women (age: 26 ± 7 year, BMI: 23 ± 3 kg m(-2), VO2max: 51 ± 11 ml kg(-1) min(-1)) performed a single 10-min REHIT cycling session (60 W and two 20-s 'all-out' sprints), with vastus lateralis biopsies taken before and 0, 30, and 180 min post-exercise for analysis of glycogen content, phosphorylation of AMPK, p38 MAPK and ACC, and gene expression of PGC1α and GLUT4...
November 2015: European Journal of Applied Physiology
Felix Beuschlein, Jens Weigel, Wolfgang Saeger, Matthias Kroiss, Vanessa Wild, Fulvia Daffara, Rosella Libé, Arianna Ardito, Abir Al Ghuzlan, Marcus Quinkler, Andrea Oßwald, Cristina L Ronchi, Ronald de Krijger, Richard A Feelders, Jens Waldmann, Holger S Willenberg, Timo Deutschbein, Anthony Stell, Martin Reincke, Mauro Papotti, Eric Baudin, Frédérique Tissier, Harm R Haak, Paola Loli, Massimo Terzolo, Bruno Allolio, Hans-Helge Müller, Martin Fassnacht
BACKGROUND: Recurrence of adrenocortical carcinoma (ACC) even after complete (R0) resection occurs frequently. OBJECTIVE: The aim of this study was to identify markers with prognostic value for patients in this clinical setting. DESIGN, SETTING, AND PARTICIPANTS: From the German ACC registry, 319 patients with the European Network for the Study of Adrenal Tumors stage I-III were identified. As an independent validation cohort, 250 patients from three European countries were included...
March 2015: Journal of Clinical Endocrinology and Metabolism
Riddhi A Modi, Gerald McGwin, Andrew O Westfall, Deon W Powell, Greer A Burkholder, James L Raper, James H Willig
The purpose of this study was to explore factors associated with venous thromboembolism (VTE) among a cohort of HIV-infected patients and to describe early outcomes of warfarin anticoagulation therapy treated in a pharmacist-based anticoagulation clinic (ACC). A nested case-control study was conducted using the University of Alabama at Birmingham 1917 HIV Clinic Cohort. Conditional logistic regression was used to estimate factors associated with VTE. Among HIV-infected VTE cases, ACC-managed patients were compared to primary care provider (PCP)-managed patients to determine Time within Therapeutic INR Range (TTR)...
October 2015: International Journal of STD & AIDS
Shengli Li, Yajuan Zhang, Shoujun Li, Xu Wang, Rongyuan Zhang, Zhongyuan Lu, Jun Yan
INTRODUCTION: This study examined early postoperative results to identify perioperative factors that are associated with prolonged mechanical ventilation (PMV) in tetralogy of Fallot (TOF) patients undergoing corrective surgery. METHODS: We retrospectively examined the role of perioperative variables in determining the period of mechanical ventilatory support in TOF patients undergoing corrective surgery. A total of 821 patients were included in the study. The cohort was divided into a PMV group that included patients with >90th percentile for duration of mechanical ventilation and a non-PMV group which included all other patients...
May 2015: Congenital Heart Disease
Xiulan Liu, Jing Zhang, Hongyan Zhao, Hongxia Mei, Qingquan Lian, Wangning Shangguan
BACKGROUND: Previous studies have shown that a low dose of propofol IV bolus had a beneficial effect on intrathecal morphine-induced pruritus in humans. However, its exact mechanism has not been fully understood. In this study, we hypothesized that propofol relieved intrathecal morphine-induced pruritus in rats by upregulating the expression of cannabinoid-1 (CB[1]) receptors in anterior cingulate cortex (ACC). METHODS: Twenty-four Sprague-Dawley rats were divided into a control group and 20, 40, 80 μg/kg morphine groups to create an intrathecal morphine-induced scratching model...
February 2014: Anesthesia and Analgesia
Yu-Chen Tseng, Seng-Tang Wu, Tai-Kuang Chao, Ching-Jiunn Wu, Tom Chau, Sung-Sen Yang
Hormonally inactive adrenocortical carcinoma (ACC) is a rare disease where abdominal discomfort and back pain are common presenting symptoms due to mass effect from a large tumor. Acute kidney injury (AKI) from retroperitoneal tumors has rarely been reported. The most common etiologies include venous thrombosis, ureteral compression, or both. Here, we described a man who presented with AKI from a large retroperitoneal tumor, which was finally diagnosed as a non-functional ACC. The inferior vena cava (IVC) was nearly completely compressed by the large retroperitoneal tumor leading to venous outflow obstruction and AKI...
June 2014: International Urology and Nephrology
Ling Ni, Rongfeng Qi, Long Jiang Zhang, Jianhui Zhong, Gang Zheng, Xingjiang Wu, Xinxin Fan, Guang Ming Lu
PURPOSE: The exact neuro-pathophysiological effect of transjugular intrahepatic portosystemic shunt (TIPS) on brain function remains unclear. The purpose of this study was to investigate the longitudinal brain activity changes in cirrhotic patients with TIPS insertion using resting-state functional MRI (fMRI) with regional homogeneity (ReHo) method. METHODS: Fifteen cirrhotic patients without overt hepatic encephalopathy (OHE) planned for TIPS procedure and 15 age- and gender-matched healthy controls were included in this study...
March 2014: European Journal of Radiology
Matthieu Biais, Joachim Calderon, Mathieu Pernot, Laurent Barandon, Thierry Couffinhal, Alexandre Ouattara, François Sztark
OBJECTIVE: Infrarenal aortic cross-clamping (ACC) induces hemodynamic disturbances that may affect respiratory-induced variations in stroke volume and, therefore, affect the ability of dynamic parameters such as pulse-pressure variation (PPV) to predict fluid responsiveness. Since this issue has not been investigated yet to authors' knowledge, the hypothesis was tested that ACC may change PPV and impair its ability to predict fluid responsiveness. DESIGN: Prospective laboratory experiment...
December 2013: Journal of Cardiothoracic and Vascular Anesthesia
Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Akihito Kozuki, Toshio Nakamura
AIM: To distinguish acinar cell carcinoma (ACC) from pancreatic adenocarcinoma (AC) by comparing their computed tomography findings. METHODS: Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens. The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases (non-contrast, arterial, portal venous, and delayed phase) were compared...
September 14, 2013: World Journal of Gastroenterology: WJG
Gian Paolo Rossi, Lorenzo A Calò, Giuseppe Maiolino, Carmine Zoccali
A significant proportion of patients treated for acute decompensated heart failure (ADHF) suffer from worsening renal function, which is often associated with medical therapy resistance and poor outcome. In this setting, haemofiltration has been used for more than 30 years, despite inconclusive evidence for its advantages. In the last decade, a major technological advances have made available a new technique, ultrafiltration, which works at lower blood flow rates and requires only a venous access. As in a first proof-of-concept study (EUPHORIA), ultrafiltration proved to be efficacious in fluid removal in ADHF patients; this treatment was further investigated in randomized controlled trials...
July 2014: Nephrology, Dialysis, Transplantation
Pei-Yu Lee, Sora Y Han, Randell K Miyahara
PURPOSE: The results of a study to determine whether pharmacist monitoring in the crucial first months of dabigatran therapy in patients with atrial fibrillation or flutter can help optimize adherence and stroke-prevention outcomes are presented. METHODS: A retrospective preimplementation-postimplementation study was conducted at a Veterans Affairs (VA) hospital to evaluate dabigatran adherence and treatment outcomes in a group of patients whose therapy was monitored by anticoagulation clinic (ACC) pharmacists (n = 20) and a historical comparison group (n = 48) that received usual care (UC)...
July 1, 2013: American Journal of Health-system Pharmacy: AJHP
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