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Expandable sheath or e-sheath

Christine D Plant, Giles W Plant
Schwann cells are the primary inducers of regeneration of the peripheral nervous system. Schwann cells can be isolated from adult peripheral nerves, expanded in large numbers, and genetically transduced by viral vectors in vitro prior to their use in vivo. Here we describe how to use lentiviral vectors to transduce primary Schwann cells in vitro. We also describe how cultured Schwann cells can be used in conjunction with decellularized peripheral nerve sheaths prepared by multiple freeze thawing of peripheral nerve tissue...
2018: Methods in Molecular Biology
Mohammed Rashid Akhtar, Jimmy Kyaw Tun, Riad Alchanan, Ounali Jaffer, Snehal Patel, Joo-Young Chun, Nicholas Bunker, Tim Fotheringham
There has been increasing use of a novel combined femoral venous sheath, catheter and retrievable self-expanding and collapsible diamond-shaped IVC filter (Angel® Catheter, BiO2 Medical), in severely injured patients who cannot receive anticoagulation. As the filter is not detached from the catheter/sheath, it should be easily retrieved. Outcomes included in large registries demonstrate a high safety profile and a 100% retrieval rate. However, at our institution-a Level 1 major UK trauma centre with 4 years of substantial experience in using this device-we've encountered three cases of device fracture and subsequent complicated retrieval dating from Dec 2016 to March 2017...
March 14, 2018: Cardiovascular and Interventional Radiology
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Neil H Riordan, Isabela Morales, Giselle Fernández, Nicole Allen, Neal E Fearnot, Michael E Leckrone, Dedra Jones Markovich, Darla Mansfield, Dorita Avila, Amit N Patel, Santosh Kesari, Jorge Paz Rodriguez
BACKGROUND: Multiple sclerosis (MS) is a progressively debilitating neurological condition in which the immune system abnormally erodes the myelin sheath insulating the nerves. Mesenchymal stem cells (MSC) have been used in the last decade to safely treat certain immune and inflammatory conditions. METHODS: A safety and feasibility study was completed on the use of umbilical cord MSC (UCMSC) as a treatment for MS. In this 1-year study, consenting subjects received seven intravenous infusions of 20 × 106 UCMSC over 7 days...
March 9, 2018: Journal of Translational Medicine
Maria Anna Hulens, Wim Dankaerts, Ricky Rasschaert, Frans Bruyninckx, Marie-Laure Willaert, Charlotte Vereecke, Greet Vansant
BACKGROUND: Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI...
February 17, 2018: Acta Neurochirurgica
E Gallitto, M Gargiulo, G Faggioli, A Sonetto, C Mascoli, R Pini, M Abualhin, A Stella
PURPOSE: To describe an endovascular technique to close a renal artery fenestration during fenestrated endograft implant for a para-renal aneurysm (p-AAA) without interfering with other visceral vessels REPORT: A 76-year-old-male with p-AAA underwent repair by a four fenestrations custom-made endograft. At the intra-procedural angiography, the right renal artery was occluded. In order to avoid a high-flow endoleak from fenestration, we performed the following technique: a 9F-steerable sheath was used to advance a 7F-sheath through the fenestration into aneurism...
February 5, 2018: Annals of Vascular Surgery
Sun-Hwa Nam, Jin Il Kwak, Youn-Joo An
Soil algae, which have received attention for their use in a novel bioassay to evaluate soil toxicity, expand the range of terrestrial test species. However, there is no information regarding the toxicity of nanomaterials to soil algae. Thus, we evaluated the effects of silver nanoparticles (0-50 mg AgNPs/kg dry weight soil) on the soil alga Chlamydomonas reinhardtii after six days, and assessed changes in biomass, photosynthetic activity, cellular morphology, membrane permeability, esterase activity, and oxidative stress...
January 10, 2018: Scientific Reports
Patrick Paullus, Taylor A Wilson, Paul Lee, Arunprasad Gunasekaran, Noojan Kazemi
In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used for interbody fusion procedures, the location of the tumor allowed this minimally invasive approach resulting in excellent access, minimal soft-tissue injury, and a short hospital stay. The authors present this approach as a less invasive and yet effective technique for resection of otherwise difficult-to-access nerve lesions...
January 2018: Neurosurgical Focus
Roger J Packer, Michael J Fisher, Gary Cutter, Karen Cole-Plourde, Bruce R Korf
Neurofibromatosis type 1 and type 2, affecting both children and adults, often results in devastating complications. The rapid unravelling of the genetic underpinnings of these unique disorders has led to the development of novel therapies, especially molecular-targeted therapies. To facilitate clinical trial development, the Neurofibromatosis Clinical Trial Consortium (NFCTC) was established in 2006 by the Department of Defense. Over the past decade, the Consortium has successfully completed studies for children and adults with neurofibromatosis type 1 and plexiform neurofibromas, neurocognitive challenges, low-grade gliomas, and malignant peripheral nerve sheath tumors...
January 2018: Journal of Child Neurology
James M Tracey, Galina Gagin, Duncan Morhardt, John M Hollingsworth, Khurshid R Ghani
INTRODUCTION & OBJECTIVE: Recently there has been interest in a dusting technique for lithotripsy during ureteroscopy (URS) utilizing high frequency and low pulse energy (HiFr-LoPE) settings. We assessed a 120 Watt holmium laser that permits high frequency (>50 Hz) dusting. MATERIALS AND METHODS: Consecutive URS cases performed by a single surgeon using the P120H (Lumenis, San Jose, CA) were reviewed. Lithotripsy was performed using HiFr-LoPE settings [50-80 Hz /0...
December 14, 2017: Journal of Endourology
Alberto Barioli, Massimo Napodano, Giuseppe Tarantini
Newer generation of self-expandable nitinol coronary stents has proven to be useful in the treatment of bifurcations, tapered vessels, thrombotic lesions, venous grafts and ectatic segments. However, optimal device positioning can be cumbersome, due to the peculiar delivery mechanism which consists of retracting an outer sheath in order to release the stent from the distal edge. We report the case of a 53-year-old man, admitted for unstable angina. Coronary angiography showed a tight stenosis of the proximal left anterior descending coronary artery...
December 2017: Giornale Italiano di Cardiologia
Palle J S Osther
Currently, indications for flexible ureterorenoscopy (fURS) are expanding, mainly due to technological advancements. Although data from clinical series definitely presents fURS as a safe procedure, serious complications including sepsis and ureteral lesions do occur. These complications seem to be a result of the unique elements of fURS, ureteral access and irrigation, pushing normal upper urinary tract physiology into pathophysiological processes, including intrarenal/pyelo-veneous backflow and ureteral contractions, potentially resulting in septic, haemorrhagic and ureteral lesional complications...
November 18, 2017: Urolithiasis
Christine S Higham, Seth M Steinberg, Eva Dombi, Arie Perry, Lee J Helman, Scott M Schuetze, Joseph A Ludwig, Arthur Staddon, Mohammed M Milhem, Daniel Rushing, Robin L Jones, Michael Livingston, Stewart Goldman, Christopher Moertel, Lars Wagner, David Janhofer, Christina M Annunziata, Denise Reinke, Lauren Long, David Viskochil, Larry Baker, Brigitte C Widemann
Background: Worse chemotherapy response for neurofibromatosis type 1- (NF1-) associated compared to sporadic malignant peripheral nerve sheath tumors (MPNST) has been reported. Methods: We evaluated the objective response (OR) rate of patients with AJCC Stage III/IV chemotherapy-naive NF1 MPNST versus sporadic MPNST after 4 cycles of neoadjuvant chemotherapy, 2 cycles of ifosfamide/doxorubicin, and 2 cycles of ifosfamide/etoposide. A Simon optimal two-stage design was used (target response rate 40%)...
2017: Sarcoma
Mara L Schuler, Olga V Sedelnikova, Berkley J Walker, Peter Westhoff, Jane A Langdale
The co-ordinated positioning of veins, mesophyll cells and stomata across a leaf is crucial for efficient gas exchange and transpiration, and therefore for overall function. In monocot leaves, stomatal cell files are positioned at the flanks of underlying longitudinal leaf veins, rather than directly above or below. This pattern suggests either that stomatal formation is inhibited in epidermal cells directly in contact with the vein, or that specification is induced in cells files beyond the vein. The SHORTROOT pathway specifies distinct cell-types around the vasculature in sub-epidermal layers of both root and shoots, with cell-type identity determined by distance from the vein...
November 10, 2017: Plant Physiology
Hirofumi Kamachi, Toshiya Kamiyama, Yousuke Tsuruga, Tatsuya Orimo, Kenji Wakayama, Shingo Shimada, Tatsuhiko Kakisaka, Hideki Yokoo, Kenichiro Yamashita, Akinobu Taketomi
PURPOSE: To increase the surgical opportunities for locally advanced perihilar bile duct cancers that require left-sided hepatectomies, we developed the transparenchymal glissonean approach (TGA); it comprises intra-hepatic exposure and dissection of the Glisson's sheath to gain access to the hepatic artery and portal vein for reconstruction. METHODS: Following skeletonization of the hepatoduodenal ligament, the proximal portions of invaded vessels are exposed. If extra-hepatic attempts to access the distal portions of the invaded vessels fail, TGA can be used...
October 23, 2017: Langenbeck's Archives of Surgery
H J Pei, S Y Teng, T Luo, Y J Wu, Y J Yang, S B Qiao, B Xu, R L Gao
Objective: To investigate the safety and feasibility of sheathless transfemoral aortic valve replacement (TAVR). Methods: In this prospective study, we enrolled 23 patients with severe aortic stenosis (AS) who were inoperable or at high-risk for surgical aortic valve replacement operation in Fuwai hospital From September 2012 to June 2015. Multislice spiral CT and angiography of femoral artery showed that all patients had minimal femoral artery diameters (<6.5 mm) and severe calcification which was not suitable for transfemoral TAVR through sheath...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
Hirokazu Onishi, Toru Naganuma, Sunao Nakamura
Percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI) is generally an acceptable procedure but may be associated with vascular complications at femoral access sites, particularly in obese patients. This report aimed to describe a case of successful performance of our "double crossover technique" in an obese patient undergoing TF-TAVI with a percutaneous transfemoral intra-aortic balloon pump (TF-IABP). A 75-year-old man presented with heart failure due to a left ventricular ejection fraction of 35% and low-flow, low-gradient severe aortic stenosis...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Zisis Dimitriadis, Werner Scholtz, Stephan M Ensminger, Cornelia Piper, Thomas Bitter, Marcus Wiemer, Marios Vlachojannis, Jochen Börgermann, Lothar Faber, Dieter Horstkotte, Jan Gummert, Smita Scholtz
OBJECTIVE: Evaluation of the impact of the sheath diameter on vascular complications and mortality in transfemoral aortic valve implantation. METHOD: Between 2012 and 2014, 183 patients underwent the procedure using a sheath diameter of 18-24 F. This collective was divided into two groups: group 1, with a sheath diameter of 18F (G1, n = 94), consisted of patients with 18F Medtronic Sentrant and 18 F Direct Flow sheaths, and group 2 with a sheath diameter of 19-24 F (G2, n = 89) consisted of patients with Edwards expandable e-sheath and Solopath sheaths...
2017: PloS One
Jennifer S W Campbell, Ilana R Leppert, Sridar Narayanan, Mathieu Boudreau, Tanguy Duval, Julien Cohen-Adad, G Bruce Pike, Nikola Stikov
The fiber g-ratio is the ratio of the inner to the outer diameter of the myelin sheath of a myelinated axon. It has a limited dynamic range in healthy white matter, as it is optimized for speed of signal conduction, cellular energetics, and spatial constraints. In vivo imaging of the g-ratio in health and disease would greatly increase our knowledge of the nervous system and our ability to diagnose, monitor, and treat disease. MRI based g-ratio imaging was first conceived in 2011, and expanded to be feasible in full brain white matter with preliminary results in 2013...
August 16, 2017: NeuroImage
Lovro Tkalčić, Berislav Budiselić, Miljenko Kovačević, Siniša Knežević, Slavica Kovačić, Damir Miletić, Vjekoslav Tomulić, Dimitrij Kuhelj
BACKGROUND: An aneurysm of the superior mesenteric artery (SMA) with a diameter of 2.2 cm was found incidentally on an ultrasound (US) examination in a 26-year-old woman. The only known risk factor was an intracranial aneurysm that was found on her grandmother's autopsy. Based on pregnancy planning and the current literature, endovascular management with a covered stent was proposed. CASE REPORT: Self-expandable, covered stent (Bard, Fluency(®)) was implanted using a single transfemoral approach...
2017: Polish Journal of Radiology
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