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Rohit Mathur, Sanjeev Sanghvi, Anil Baroopal
Lutembacher syndrome is a rare cardiac abnormality characterized by a combination of congenital atrial septal defect (ASD) and acquired rheumatic mitral stenosis (MS). Here we report a case of 18-year-old male with Lutembacher syndrome successfully treated percutaneously with transcatheter Accura balloon valvuloplasty and Amplatzer septal occluder device closure.
January 2018: Journal of the Association of Physicians of India
Takaya Tokuhara, Eiji Nakata, Toshiyuki Tenjo, Isao Kawai, Keisaku Kondo, Hirofumi Ueda, Atsushi Tomioka
BACKGROUND: The drawback of intracorporeal esophagojejunostomy with the double-stapling technique (DST) using a transorally inserted anvil (OrVil™, Covidien, Mansfield, MA, USA) following laparoscopic total gastrectomy (LTG) is not only the high incidence of stenosis but also the presence of intractable stenosis that is refractory to endoscopic treatments. METHODS: From November 2013 to December 2016, 24 patients with gastric cancer underwent intracorporeal circular-stapled esophagojejunostomy with the hemi-double-stapling technique (hemi-DST) using the OrVil™ in antecolic Roux-en-Y reconstruction with its efferent loop located on the left side of the patient following LTG to prevent twisting of the esophagojejunostomy and lifted jejunum, which might cause intractable stenosis of the esophagojejunostomy...
October 19, 2018: Surgical Endoscopy
Yu Sugawara, Tomoya Ueda, Tsunenari Soeda, Makoto Watanabe, Hiroyuki Okura, Yoshihiko Saito
Percutaneous coronary intervention (PCI) for heavily calcified lesions is challenging because these lesions are resistant to balloon dilatation and stenting. Lacrosse non-slip element (NSE) may have the potential to dilate heavily calcified lesions. We aimed to investigate predictors of successful lesion modification using Lacrosse NSE angioplasty via optical coherence tomography (OCT)-guided PCI. We investigated 32 patients with severe target lesion calcification treated with OCT-guided PCI. Successful lesion modification was defined as the complete fracture of calcification after Lacrosse NSE angioplasty...
October 19, 2018: Cardiovascular Intervention and Therapeutics
Yosuke Fukushima, Kenji Baba, Maiko Kondo, Yoshihiko Kurita, Takahiro Eitoku, Shigemitsu Yusuke, Kenta Hirai, Hirokazu Tsukahara, Tatsuo Iwasaki, Shingo Kasahara, Kotani Yasuhiro, Shinichi Otsuki
BACKGROUND: Rashkind balloon atrial septostomy (BAS) can be challenging in infants with hypoplastic left heart syndrome (HLHS) and small atrial septal defects (ASD). METHODS: We retrospectively reviewed all infants with HLHS who underwent surgery and BAS between January 2006 and December 2015. The infants were divided into three groups: no BAS, catheter BAS, and open BAS. Infants who underwent catheter BAS were divided into two groups based on atrial septal anatomy: standard and complex...
October 19, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Anita Karsa, Shonit Punwani, Karin Shmueli
PURPOSE: Quantitative susceptibility mapping (QSM) has found increasing clinical applications. However, to reduce scan time, clinical acquisitions often use reduced resolution and coverage, particularly in the through-slice dimension. The effect of these factors on QSM has begun to be assessed using only balloon phantoms and downsampled brain images. Here, we investigate the effects (and their sources) of low resolution or coverage on QSM using both simulated and acquired images. METHODS: Brain images were acquired at 1 mm isotropic resolution and full brain coverage, and low resolution (up to 6 mm slice thickness) or coverage (down to 20 mm) in 5 healthy volunteers...
October 19, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Andrés José Del Pozo-García, Carlos Piedracoba-Cadahia, Fernando Sánchez-Gómez, José Carlos Marín-Gabriel, Sarbelio Rodríguez-Muñoz
We present a case of intractable dysphagia in a 23-year-old female with type 1 esophageal atresia (EA) and subsequent postsurgical refractory esophageal strictures. The patient was referred due to increasing symptomatology and a slight response to balloon dilations. A biodegradable polydioxanone stent (ELLA) was placed, but this did not relieve the dysphagia. After the sequential placement of two siliconated polypropylene stents (Polyflex™, Boston Scientifics), the dysphagia was definitively relieved. To our knowledge, this is the first published case with a full resolution of dysphagia using this strategy in an adult patient...
September 3, 2018: Revista Española de Enfermedades Digestivas
Ceren Durer, Seren Durer, Mohamad Sharbatji, Isin Y Comba, Ilan Aharoni, Umair Majeed
Hemangiomas of the small intestine are rare and very difficult to diagnose preoperatively. Clinical presentations may include occult or massive gastrointestinal (GI) bleeding, obstruction, intussusception, and perforation. We report a 66-year-old Caucasian male patient with severe anemia secondary to occult GI bleeding from a cavernous hemangioma in the jejunum. A double balloon enteroscopy following capsule endoscopy was performed to obtain biopsy samples, which established the final diagnosis.
August 6, 2018: Curēus
Ju Han, Jun Zhang, Xiao Zhang, Jinping Zhang, Yun Song, Wei Zhao, Meimei Zheng, Lili Sun, Wei Wang
BACKGROUND: The optimal treatment for patients with symptomatic severe intracranial atherosclerotic disease is not well established. Angioplasty and stenting have been attempted, with controversial results, mainly attributed to perioperative complications and a high incidence of restenosis or in-stent restenosis. Drug-coated balloons (DCBs) have shown encouraging results for coronary and peripheral artery disease, without convincing data for intracranial vasculature. OBJECTIVES: To assess the feasibility, clinical and angiographic outcomes of DCBs for patients with intracranial de novo atherosclerotic disease...
October 18, 2018: Journal of Neurointerventional Surgery
James M Meza, Martijn Slieker, Eugene H Blackstone, Luc Mertens, William M DeCampli, James K Kirklin, Mohsen Karimi, Pirooz Eghtesady, Kamal Pourmoghadam, Richard W Kim, Phillip T Burch, Marshall L Jacobs, Tara Karamlou, Brian W McCrindle
BACKGROUND: Qualitative features of aortic and mitral valvar pathology have traditionally been used to classify congenital cardiac anomalies for which the left heart structures are unable to sustain adequate systemic cardiac output. We aimed to determine if novel groups of patients with greater clinical relevance could be defined within this population of patients with critical left heart obstruction (CLHO) using a data-driven approach based on both qualitative and quantitative echocardiographic measures...
October 2018: Computer Methods and Programs in Biomedicine
Ryan B Budde, Muhammad A Arafat, Daniel J Pederson, Thelma A Lovick, John G R Jefferys, Pedro P Irazoqui
OBJECTIVE: Recent research suggests that obstructive laryngospasm and consequent respiratory arrest may be a mechanism in sudden unexpected death in epilepsy. We sought to test a new hypothesis that this laryngospasm is caused by seizures driving reflux of stomach acid into the larynx, rather than spontaneous pathological activity in the recurrent laryngeal nerve. APPROACH: We used an acute kainic acid model under urethane anesthesia to observe seizure activity in Long-Evans rats...
October 9, 2018: Epilepsy Research
Jae-Hyung Roh, Young-Hak Kim, Hee Jun Kang, Pil Hyung Lee, Sung-Han Yoon, Mineok Chang, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
This study aimed to investigate the feasibility and safety of the modified balloon crush technique.The conventional crush technique accompanies difficult and suboptimal final kissing balloon inflation (FKI)In a single-center percutaneous coronary intervention registry, 515 patients with 515 bifurcation lesions were treated with the modified balloon technique (n = 70) or the conventional crush technique (n = 445). In contrast to the conventional crush technique, where the implanted side branch (SB) stent is crushed by expansion of the main branch (MB) stent, the modified balloon crush technique uses balloon crushing and additional SB ballooning across the crushed SB stent before MB stenting to facilitate FKI...
October 2018: Medicine (Baltimore)
Ming Wei, Yuxiang Ma, Long Yin
INTRODUCTION: The endovascular treatment of intracranial atherosclerotic stenosis has become a common intervention. However, few reports are available regarding stenting performed for hypoplastic vertebral artery (HVA) with multiple atherosclerotic lesions. Combining multiple neuroendovascular devices provides more possibilities for technical success. We describe a stenting technique using a distal intracranial catheter (Navien) for providing an approach to an HVA with multiple existing atherosclerotic lesions...
October 2018: Medicine (Baltimore)
Fahaid Al-Hashem, Suliman Al-Humayed, Shaimaa N Amin, Samaa S Kamar, Soheir S Mansy, Sarah Hassan, Lubna O Abdel-Salam, Mohamed Abd Ellatif, Mohammed Alfaifi, Mohamed A Haidara, Bahjat Al-Ani
The potential inhibitory effect of the antidiabetic and anti-inflammatory drug, metformin on thioacetamide (TAA)-induced hepatotoxicity associated with the inhibition of mammalian target of rapamycin (mTOR)-hypoxia-inducible factor-1α (HIF-1α) axis has not been investigated before. Therefore, we tested whether metformin can protect against liver injuries including fibrosis induced by TAA possibly via the downregulation of mTOR-HIF-1α axis and profibrogenic and inflammatory biomarkers. Rats either injected with TAA (200 mg/kg; twice a week for 8 weeks) before being killed after 10 weeks (model group) or were pretreated with metformin (200 mg/kg) daily for 2 weeks before TAA injections and continued receiving both agents until the end of the experiment, at Week 10 (protective group)...
October 18, 2018: Journal of Cellular Physiology
Bornali Kundu, John D Rolston
OBJECTIVE: The aim of this study was to report the trends in the use of common surgical interventions over the past decade to treat cranial nerve neuralgias. METHODS: The Centers for Medicare and Medicaid Services Part B National Summary Data File from 2000 to 2016 were studied. RESULTS: A total of 57.1 million persons were enrolled in 2016, up from 39.6 million persons in 2000. Suboccipital craniectomy done for cranial nerve decompressions (including cranial nerves V, VII, and IX) increased by 33...
October 18, 2018: Headache
Kentaro Tominaga, Kenya Kamimura, Junji Yokoyama, Shuji Terai
The incidence of carcinoid tumor in the small intestine is increasing; however, its preoperative diagnosis is difficult. We recently experienced three cases of multiple carcinoid tumors in the small intestine successfully detected using capsule endoscopy (CE), followed by a pathological diagnosis using double-balloon enteroscopy (DBE). To diagnose multiple carcinoid in the small intestine appropriately, we reviewed the information of five cases reported to date along with our three recent cases. The literature review demonstrated that CE and DBE are useful for detecting and diagnosing small intestinal carcinoids and tumor multiplicity, which aids in determining the appropriate resection range...
October 17, 2018: Internal Medicine
Ming Lo, Jia Zhu, Scott G Hansen, Timothy Carroll, Christina Farr Zuend, Laura Nöel-Romas, Zhong-Min Ma, Linda Fritts, Meei-Li Huang, Sijie Sun, Ying Huang, David Koelle, Louis J Picker, Adam Burgener, Lawrence Corey, Christopher J Miller
Herpes simplex virus-2 (HSV-2) is a common sexually transmitted infection with a highly variable clinical course. Many infections quickly become subclinical, with episodes of spontaneous virus reactivation. To study the host/HSV-2 interactions an animal model of subclinical HSV-2 infection is needed. In an effort to develop a relevant model, rhesus macaques (RM) were inoculated intravaginally with two or three HSV-2 strains (186, 333 and/or G); total dose 1x107 pfu HSV-2 per animal. Infectious HSV-2 and HSV-2 DNA was consistently shed in vaginal swabs for the first 7-14 days after each inoculation...
October 17, 2018: Journal of Virology
Jae Doo Joo, Dong Hee Kang, Hyon Surk Kim
Background: Orbital resorbable mesh plates are adequate to use for isolated floor and medial wall fractures with an intact bony buttress, but are not recommended to use for large orbital wall fractures that need load bearing support. The author previously reported an orbital wall restoring surgery that restored the orbital floor to its prior position through the transnasal approach and maintained temporary extraorbital support with a balloon in the maxillary sinus. Extraorbital support could reduce the load applied on the orbital implants in orbital wall restoring surgery and the use of resorbable implants was considered appropriate for the author's orbital wall restoring technique...
October 16, 2018: Archives of Craniofacial Surgery
Yongqing Zhang, Ying Yu, Luping Chen, Wei Zhao, Ketan Chu, Xiujun Han
AIMS: To investigate the risk factors of intra-amniotic infection (IAI) related to induction with single-balloon catheter (SBC). METHODS: A retrospective, case-control study including 58 cases of IAI patients who underwent induction with SBC was conducted in Women's Hospital, School of Medicine, Zhejiang University. For each case, 8 women who delivered during the same month and had no infection after SBC induction were selected for control. RESULTS: Compared with the control group, the IAI group had a higher rate of nulliparity (87...
October 17, 2018: Gynecologic and Obstetric Investigation
Tobias Tichelbäcker, Leonard Bergau, Miriam Puls, Tim Friede, Tobias Mütze, Lars Siegfried Maier, Norbert Frey, Gerd Hasenfuß, Markus Zabel, Claudius Jacobshagen, Samuel Sossalla
BACKGROUND: Permanent pacemaker implantation (PPI) following TAVR is a frequent post interventional complication and its management remains controversial. OBJECTIVE: We sought to elucidate the electrophysiological, procedural, and clinical baseline parameters that are associated with and perhaps predict the need for PPI after TAVR in a heterogeneous-valve-type real-world cohort. METHODS: Overall, 494 patients receiving TAVR at our center from April 2009 to August 2015 were screened...
2018: PloS One
Alberto Larghi, Andrea Tringali, Mihai Rimbaș, Federico Barbaro, Vincenzo Perri, Gianenrico Rizzatti, Antonio Gasbarrini, Guido Costamagna
Biliary strictures represent some of the most frequent complications encountered after orthotopic liver transplantation. They comprise an array of biliary abnormalities with variations in anatomical location, clinical presentation and different pathogenesis. Magnetic resonance cholangiography represents the most accurate non-invasive imaging test that can provide detailed imaging of the whole biliary system, below and above the anastomosis. It is of particular value in those harboring complex hilar or intrahepatic strictures, offering a detailed roadmap for planning therapeutic procedures...
October 17, 2018: Liver Transplantation
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