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Chronic dissection

Tomohiko Sugiyama, Hiroshi Araki, Noritaka Ozawa, Jun Takada, Masaya Kubota, Takashi Ibuka, Masahito Shimizu
Quantitative examinations evaluating the effects of CO2 insufflation on residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection (ESD) are lacking. The present study aimed to assess whether CO2 insufflation could decrease the amount of residual gas in the gastrointestinal tract following ESD in patients with colorectal neoplasms. Computed tomography (CT) was used to objectively examine whether CO2 insufflation during colorectal ESD reduced residual gas levels in the gastrointestinal tract following ESD...
March 2018: Biomedical Reports
Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
Marco Virgilio Usai, Antje Gottschalk, Thomas Schönefeld, Johannes Frederik Schaefers, Giovanni B Torsello, Andreas Rukosujew
Aortoesophageal fistula is a rare but lethal complication after thoracic endovascular repair for thoracic aortic diseases. Extensive treatment is reserved for patients fit for surgery. Various technical approaches have been described; however, mortality rates are still high. Herein, we report a case of a 76-year-old woman with aortoesophageal fistula treated by a three-step treatment approach, with close collaboration between cardiothoracic and general surgery specialists. The patient required tracheostomy after the first procedure, but this was closed at 15 days...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Tara Talaie, Christopher Werter, Charles Drucker, Brittany O Aicher, Robert Crawford, Shahab Toursavadkohi
We report a case of a complex chronic type B aortic dissection treated by thoracic endovascular aortic repair and laser fenestration of the false septum to preserve flow to branch vessels originating from both the true and false lumen. Dissections complicated by thoracoabdominal aneurysmal degeneration with critical organs being perfused by branches arising from both true and false lumens are rare and leave limited options for repair. Despite advancements in endovascular techniques, fenestration remains one of the only means of preserving flow to both the true and false lumens and thus was necessary in the management of our patient...
April 2018: Vascular and Endovascular Surgery
Hui Jiang, Yicun Wang, Zhantao Deng, Jiewen Jin, Jia Meng, Shuo Chen, Jun Wang, Yang Qiu, Ting Guo, Jianning Zhao
Wear particle-induced osteolysis is a major cause of aseptic loosening in arthroplasty failure, but the underlying mechanism remains unclear. Due to long follow-ups necessary for detection and sporadic occurrence, it is challenging to assess the pathogenesis ofparticle-induced osteolysis in clinical cases. Hence, optimal animal models are required for further studies. The murine model of calvarial osteolysis established by exposure to CoCrMo particles is an effective and valid tool for assessing the interactions between particles and various cells in aseptic loosening...
February 17, 2018: Journal of Visualized Experiments: JoVE
I A Filatova
By improving the existing surgical technologies for dacryocystitis, one enhances the effectiveness of patient rehabilitation. AIM: To evaluate the effectiveness of radio-wave surgery in the treatment of dacryocystitis and lacrimal sac abscesses. MATERIAL AND METHODS: The clinical group consisted of 207 patients ranging in age from 7 to 89 years (the mean age of 41±7.3 years). For 39% of patients this was a repeated treatment, while 9.3% had undergone 4-5 surgical interventions...
2018: Vestnik Oftalmologii
Lihui Weng, Davis Seelig, Omid Souresrafil
PURPOSE: To determine the physiologic response to resorbable carboxymethyl cellulose/chitosan (CMC/CN) microspheres in a long-term rabbit model, including the clinical response, gross pathology, and histopathology. MATERIALS AND METHODS: Six rabbits were embolized with CMC/CN microspheres (300-500 µm) in one kidney via an inferior renal artery branch. Angiography was performed immediately before and after embolization and prior to killing at 6 months (180 ± 7 days, n = 3) and 12 months (365 ± 10 days, n = 3)...
March 14, 2018: Cardiovascular and Interventional Radiology
Yu-Chen Lu, Yu-Jun Wang, Bin Lu, Ming Chen, Ping Zheng, Jing-Gen Liu
Itch is an unpleasant sensation that initiates scratching behavior. Itch-scratch reaction is a complex phenomenon whose occurrence implicates supraspinal structures required for regulation of sensory, emotional, cognitive, and motivational aspects. However, the central mechanisms underlying the processing of itch and the interplay of the supraspinal regions and spinal cord in regulating itch-scratch processes are poorly understood. Here, we have identified that the neural projections from anterior cingulate cortex (ACC) to dorsal medial striatum (DMS) constitute a critical circuit element for regulating itch-related behaviors in the brain of male C57BL/6J mice...
March 14, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Natasha Pollak
The development of endoscopic ear surgery techniques promises to change the way we approach ear surgery. In this review paper, we explore the current evidence, seek to determine the advantages of endoscopic ear surgery, and see if these advantages are both measureable and meaningful. The wide field of view of the endoscope allows the surgeon to better visualize the various recesses of the middle ear cleft. Endoscopes make it possible to address the target pathology transcanal, while minimizing dissection or normal tissue done purely for exposure, leading to the evolution of minimally-invasive ear surgery and reducing morbidity...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Takahiro Mizoguchi, Nobuya Zempo, Yoshikazu Kaneda
We examined the outcomes of aortic remodeling for chronic type B aortic dissection (cTBD) after thoracic endovascular aneurysm repair (TEVAR). Objective & Methods : Thirty-eight patients underwent TEVAR for cTBD at our institution. We classified cTBD patients into the early cTBD group (16 cases, 2 weeks-4 months from onset) and late cTBD group (22 cases, >4 months from onset). Results : There were no cases of paraplegia, stroke, and hospital death in both groups. There was no worsening of complicated cases...
December 25, 2017: Annals of Vascular Diseases
Ourania Preventza, Matt D Price, Hiruni S Amarasekara, Adam Tullos, Peter Chen, Michael R Reidy, Gregory Pattakos, Kim I de la Cruz, Qianzi Zhang, Joseph S Coselli
OBJECTIVES: To compare short-term outcomes, long-term survival and reinterventions in patients requiring surgery after chronic Type I and chronic primary Type III aortic dissections. METHODS: Over an 11-year period, 466 patients underwent thoraco-abdominal aortic aneurysm repair for chronic Type III (n = 239) and Type I (n = 227) aortic dissections. Short-term outcomes and reinterventions were evaluated by multivariable regression analysis for the entire group; propensity matching produced 169 pairs...
March 2, 2018: European Journal of Cardio-thoracic Surgery
Luca Parisi, Elisabetta Gini, Denisa Baci, Marco Tremolati, Matteo Fanuli, Barbara Bassani, Giampietro Farronato, Antonino Bruno, Lorenzo Mortara
Macrophages are key cellular components of the innate immunity, acting as the main player in the first-line defence against the pathogens and modulating homeostatic and inflammatory responses. Plasticity is a major feature of macrophages resulting in extreme heterogeneity both in normal and in pathological conditions. Macrophages are not homogenous, and they are generally categorized into two broad but distinct subsets as either classically activated (M1) or alternatively activated (M2). However, macrophages represent a continuum of highly plastic effector cells, resembling a spectrum of diverse phenotype states...
2018: Journal of Immunology Research
Rizwan Faisal, Nisar Ahmad, Yahya Saleem Fahad, Sadia Chiragh
Background: Rheumatoid arthritis inflammatory joint disease which is chronic in nature. Since long various researches are carried out to find the remedy of this disease but still a lot of work needed to be done. Methods: This comparative study was performed from March to August 2013 at Postgraduate Medical Institute, Lahore. A total of thirty-two female Sprague-Dawley rats were randomly divided into four equal groups (n=8); group A was kept as healthy control, group B was kept as positive control, group C was treated with thymoquinone and group D was treated with methotrexate...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Satoshi Kawatsu, Konosuke Sasaki, Ko Sakatsume, Shingo Takahara, Katsuhiro Hosoyama, Naoki Masaki, Yusuke Suzuki, Yukihiro Hayatsu, Ichiro Yoshioka, Kei Sakuma, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Naotaka Motoyoshi, Shunsuke Kawamoto, Yoshikatsu Saiki
BACKGROUND: Heparin resistance is often encountered during cardiovascular surgery using cardiopulmonary bypass. Clinical risk factors and the mechanism underlying heparin resistance are yet to be determined. The aim of this study was to elucidate the clinically valid preoperative predictors related to heparin resistance. METHODS: A total of 489 patients undergoing cardiovascular surgery were evaluated. Of these, 25 patients presented with heparin resistance (HR) and received antithrombin III administration for the initiation of cardiopulmonary bypass with an effective activated coagulation time...
March 1, 2018: Annals of Thoracic Surgery
Keisuke Miyake, Toshihiro Funatsu, Haruhiko Kondoh, Kazuhiro Taniguchi
INTRODUCTION: Despite the technical improvements, redo surgery on the aortic root and arch is still associated with high morbidity and mortality due to the trauma of repeat open-heart surgery and technical complexity. We present the case of extended chronic type A dissecting aneurysm that developed after a Bentall operation, which was successfully treated by applying a modified long elephant trunk technique and surgical aortic fenestration. CASE PRESENTATION: A 77-year-old man, who had previously undergone a Bentall procedure and an abdominal surgery, developed a type A aortic dissection...
December 12, 2017: International Journal of Surgery Case Reports
Michiel Vandenbosch, Tomas Somers, Eva Cuypers
In forensic toxicology, when extended time has elapsed before discovery of the body, the most commonly analyzed specimens are often degraded or not available at all due to decomposition. In this case, skeletal tissue may be the only specimen left. Nevertheless, very limited research is found on the drug disposition in bone, making toxicological interpretation very difficult. Since methadone is linked to almost 50% of drug abuse fatalities in Belgium, an easy extraction and quantification method was developed and validated to investigate the distribution pattern of methadone and its metabolites in skeletal tissue after chronic dosing...
February 27, 2018: Journal of Analytical Toxicology
R E Clough, R Spear, K Van Calster, A Hertault, R Azzaoui, J Sobocinski, D Fabre, S Haulon
BACKGROUND: Surgical repair of aortic arch pathology is complex and associated with significant morbidity and mortality. Alternative approaches have been developed to reduce these risks, including the use of thoracic stent-grafts with fenestrations or in combination with bypass procedures to maintain supra-aortic trunk blood flow. Branched stent-grafts are a novel approach to treat aortic arch pathology. METHODS: Consecutive patients with aortic arch disease presenting to a single university hospital vascular centre were considered for branched stent-graft repair (October 2010 to January 2017)...
March 2018: British Journal of Surgery
D Boccara, K Serror, M Mimoun, M Chaouat
INTRODUCTION: Cicatricial complications after abdominal or pelvic surgery are more frequent in obese patients. In this case, infection, seroma and delays in scarring can be extremely difficult to treat. The objective of this technical note is to present an original case of an obese patient operated nine years ago of a hysterectomy by laparotomy and chronically presenting a non-resolving septic seroma despite multiple surgical procedures whose healing could be obtained by a flap of greater omentum...
February 24, 2018: Annales de Chirurgie Plastique et Esthétique
Alberto Goldman, Uwe Wollina, Katlein França, Georgi Tchernev, Torello Lotti
Abdominoplasty is listed among five most common esthetic surgical procedures in the Western World. Despite all efforts, abdominoplasty bears a high risk of complications. We observed a 39-year-old-woman with previous classical abdominoplasty performed elsewhere three years ago. Clinical examination demonstrated a swollen and tense abdominal mass. Laboratory findings were normal. Clinical examination was completed by abdominal ultrasonography which demonstrated both, a significant fluid volume in this area and a dense fibrous "capsule"...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Daniel A Waxman, Hemal K Kanzaria, David L Schriger
Importance: The Institute of Medicine described diagnostic error as the next frontier in patient safety and highlighted a critical need for better measurement tools. Objectives: To estimate the proportions of emergency department (ED) visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), stroke, aortic dissection, and subarachnoid hemorrhage (SAH) that end in discharge without diagnosis; to evaluate longitudinal trends; and to identify patient characteristics independently associated with missed diagnostic opportunities...
February 26, 2018: JAMA Internal Medicine
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