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PubMed1982

[Cancer of the kidney with inferior caval thrombus. Value of a temporary caval clip].

In renal cancers with malignant thrombus in the inferior vena cava, extension and migration of the thrombus towards the right cardiac cavities may be prevented for a long time by the efferent flow of the hepatic veins acting as a haemodynamic barrier. The authors describe a new technique in which a temporary caval clip is placed in a downstream position without opening the right atrium. After thrombectomy and enlarged nephrectomy the clip is removed and a classical barrier upstreams of the renal veins/vena cava junction is installed.

Abdomen↗
PubMed2005

Providing emergency mental health care to asylum seekers at a time when claims for permanent protection have been rejected.

In total, 90% of 'boat people' who make it to Australia's migration zone are assessed as legitimate refugees and given Temporary Protection Visas (TPV) allowing them to stay in Australia for 3 years in the first instance. With an increasing number of individuals and families on TPV having their claims for a Permanent Protection Visa (PPV) rejected, this paper argues using the National Mental Health Plan 2003-2008 as a guide, for interventions that are culturally and linguistically appropriate, thus, aiming to minimize risk from exposure to extreme mental stressors in the event of an application for a PPV being rejected. Continuity and integration of mental health care involving key stakeholders is best achieved by bridging discrete elements through preparing for visa appeals and reviews, news from home and ongoing psychosocial stressors--in the context of different episodes, interventions by different providers, and changes in mental distress. To help strengthen continuity and integration of mental health supports for TPV holders, well resourced care must be experienced as connected and coherent.

Afghanistan↗
PubMed2002

[Transluminal placed endovascular graft (TPEG) for thoracic aortic disease in fifteen patients under general anesthesia].

In 15 transluminal placed endovascular graft (TPEG) operations for thoracic aortic aneurysm either from dissection or injury, we induced general anesthesia with propofol, and maintained with propofol or sevoflurane in nitrous oxide and oxygen. The temporary balloon occlusion technique used for prevention of stent migration caused hypotension (systolic pressure 30-60 mmHg) in all cases. After releasing the occluding balloon, blood pressure in each patient recovered to the prehypotension level without use of catecholamine. We experienced two emergency operations, a thoracotomy and a celiotomy, resulting from graft failure. We had sudden hypotension in two other cases. In the first patient with aortic regurgitation, coronary air embolism was suspected because of ST segment elevation, while in the other, the hypotension was due to unexpected bleeding from the femoral artery sheath. Two additional patients developed vascular injuries occurring during manipulation of the catheter or sheath. In order to manage anesthesia for TPEG, it is necessary to be aware of its complications.

Adult↗
PubMed2002

Expression of kynurenine aminotransferase in the subplate of the rat and its possible role in the regulation of programmed cell death.

The neurons of the transient subplate zone, considered important for the prenatal development of the cerebral cortex, were shown here to express kynurenine aminotransferase (KAT)-I from embryonic day (E) 16 until postnatal day (P) 7 in the rat. No other cells of brain tissue exerted KAT-I immunoreactivity during this period. From P3 on, the neurons of the subplate gave rise to KAT-I immunoreactive, varicose axons, which entered the thalamus and terminated around thalamic nerve cells that are devoid of KAT-I immunoreactivity. Other subplate markers displayed a different expression pattern during development. Thus, subplate neurons displayed parvalbumin (PV) immuno-reactivity from E16 to P10 and an intense NPY immunoreaction from P7 to P1. They also exhibited nitric oxide synthase immunoreactivity from E16 to P10, whereas on the surface of the subplate neurons, the alpha7 subunit of the nicotinic acetylcholine receptor (nAChR) was present from P1 to P10. The cells of Cajal-Retzius were nAChR-immunoreactive during this period. Between P1 and P7, the perikarya of subplate neurons also showed an intense immuno-reaction with the N-methyl-D-aspartate (NMDA) receptor subtype R2A. After the first postnatal week, many of the KAT-I positive subplate neurons display a gradual decrease of immunoreactivity and undergo programmed cell death. Since KAT-I persists in the subplate through the period E16-P7, we conclude that KAT-I is a useful and reliable subplate marker in the rat. Since it is assumed that migration of nerve cells is regulated by NMDA receptors, and since kynurenic acid--the only naturally occurring NMDA receptor antagonist--is synthesized by KAT, we suggest that a temporary breakdown of the delicate equilibrium between NMDA and KAT might induce abnormal neuronal migration, giving rise to developmental abnormalities.

Animals↗
PubMed1994

Return migration of New Zealanders: a profile of 1990 returnees.

"In the 1990s the population [of New Zealand] is experiencing higher levels of mobility than at any time in its history. However, with regards to European migration to New Zealand, the settler flows of the past have been overtaken in importance by reverse flows of temporary migrants. Now flows of new settlers come predominantly from Asia and the Pacific....This paper is about return migration--a process that has been largely ignored in the literature on international migration to New Zealand."

Demography↗
PubMed1995

[Forecast of international migration, 1994-2010].

"The estimated number of immigrants [in the Netherlands] for 1994 is 104 thousand, implying a decrease of some 15 thousand compared to the preceding year.... There were approximately 79 thousand emigrants, a slight increase (4 thousand) compared to 1993. The resulting net migration decreased from 44 thousand persons in 1993 to 25 thousand persons in 1994. In 1995 a temporary increase of (net) immigration is expected, due to the increase of the number of asylum seekers in 1994.... After 1995 projected net migration rapidly declines to 35 thousand." (SUMMARY IN ENG)

Demography↗
PubMed1992

Immigration history and the future of international migration.

"International migration must be understood as a permanent phenomenon rather than as a temporary movement. In this article, the author proceeds from the premise that in appreciating the relation between the past and the present, we may be able to draw on 'lessons of the past' to modify our definition and perception of current problems and to analyze possible policies and decisions. The article is divided into several sections, historical changes within migration patterns including different categories of migrants, various phases within the migration process in recent history, theoretical considerations in analysis, distinct types of immigration policies pursued by various states, and current and possible future trends."

Demography↗
PubMed1992

Plasmodium falciparum: release of circumsporozoite protein by sporozoites in the mosquito vector.

The release of circumsporozoite (CS) protein by Plasmodium falciparum sporozoites was investigated to identify factors regulating this process within infected Anopheles gambiae mosquitoes. The potential for sporozoites to release CS protein in vitro was not dependent upon their site-specific developmental stage (i.e., mature oocysts, hemolymph, salivary glands), their duration in the vector, or their exposure to mosquito-derived components such as salivary glands or hemolymph. The capacity of sporozoites to release CS protein was depressed by mosquito blood feeding during periods of sporozoite migration to the salivary glands, but the effect was only temporary and those sporozoites already in the glands were not affected. Free CS protein in the salivary glands was present in 93.3% of 45 infective mosquitoes. Sporozoites from these same, individual mosquitoes were also tested in vitro for CS protein release. In both cases, the amount of soluble CS protein increased as a function of sporozoite density but the total amount of CS protein per sporozoite became progressively less with increasing numbers of sporozoites. Further experiments showed that sporozoite contact with increasing amounts of soluble CS protein caused a down-regulation of CS protein release. Thus, a primary factor regulating the production and release of CS protein by sporozoites is their contact with soluble CS protein within the mosquito.

Animals↗
PubMed2002

Emergency endovascular interventions for ruptured thoracic and abdominal aortic aneurysms.

BACKGROUND: The purpose of our study was to show the effectiveness of endovascular stent grafts in the treatment of acutely ruptured abdominal and thoracic aortic aneurysms as an alternative to the conventional surgical approach in an emergency setting. METHODS: From October 1996 to October 1998 we deployed 9 emergent endovascular stent grafts--6 in the abdominal aorta and 3 in the thoracic aorta. Aortic rupture was confirmed before surgery with spiral-computed tomographic scan. The average interval from onset of symptoms to treatment was 4.5 hours. We used commercially manufactured stent grafts: 4 Corvita (Corvita Inc/Schneider Corp/Boston Scientific Corp, Natick, Mass), 3 Talent (World Medical Inc, Surise, Fla/Medtronic, Sunnyvale, Calif), and 2 Vanguard (Boston Scientific Corp, Natick, Mass). RESULTS: Deployment of the stent grafts was successful in all cases. Two patients died in the follow-up period (120 months) from myocardial infarction. No cases were seen of paraplegia or stent migration. However, 2 endoleaks, 1 in-stent stenosis, 1 temporary renal failure, and 1 brief episode of myocardial ischemia occurred. CONCLUSION: Our experiences with emergency endovascular stent grafting show that the procedure is technically feasible, with less morbidity and mortality than conventional open surgery, in selected patients.

Adult↗
PubMed2001

Vascular orientation by intra-arterial dye injection during spinal arteriovenous malformation surgery.

OBJECTIVE: Rich and complicated vascular structures on the spinal cord often interfere with obliteration of a spinal arteriovenous malformation (AVM). Vascular orientation during spinal AVM surgery is essential. The authors recently performed six consecutive spinal AVM surgeries in five patients (two with perimedullary AVMs, and three with dural arteriovenous fistulae) with the aid of intra-arterial injection of dye (indigo carmine). METHODS: Two representative cases are described. A microcatheter was placed preoperatively in the artery of interest. Subsequent to the exposure of the vascular complex, a 1-ml injection of indigo carmine (2 mg/ml) clearly demonstrated the feeding arteries and the draining veins around the AVM or dural arteriovenous fistula. RESULTS: One patient had repeat surgery because of incomplete obliteration of the AVM owing to migration of the catheter. All patients, except one who had temporary postoperative deterioration and persistent neurological deficits, had good surgical outcomes, however. No apparent side effects caused by the dye were reported. CONCLUSION: The assistance system for spinal AVM surgery is easy and safe and can be applied in other surgical institutions.

Angiography↗
PubMed2004

Ventricular tachycardia associated with transmyocardial migration of an epicardial pacing wire.

A 66-year-old man who had undergone a three-vessel coronary artery bypass grafting (CABG) procedure 3 years previously presented with ventricular tachycardia (VT) and cardiac arrest. Echocardiography demonstrated a wire coursing through the right ventricle into the pulmonary artery. The wire was removed with a snare and confirmed to be an epicardial temporary pacing wire placed during the CABG operation. We suspect that the epicardial pacing wire eroded through the right atrium and migrated into the right ventricle, contributing to the VT. Complications due to temporary epicardial pacing wires placed during CABG are discussed.

Aged↗
PubMed1999

[Adenosine-induced heart arrest for endovascular reconstruction of thoracic aneurysms of the aorta].

INTRODUCTION: Endovascular stent-graft repair is a less invasive technique than traditional open aortic reconstruction for strictly selected patients with descending thoracic aortic aneurysms. To prevent distal migration of the device as a result of the propulsive flow during systole, it is helpful to induce temporary asystole for > or = 20 s while the stent-graft is placed in the thoracic aorta. CASE STUDY: We report here a case study of a patient who was given a bolus dose of 60 mg of adenosine to induce temporary asystole. Placement of the stent-graft was successfully performed during the temporary asystole. After 45 s the patient returned to normal sinus rhythm. He was extubated 4 h after the conclusion of surgery and was discharged after 1 week. CONCLUSION: Induction of temporary asystole with bolus adenosine to facilitate placement of stent-grafts in the thoracic aorta is a simple, easy and effective method of avoiding distal device migration.

Adenosine↗
PubMed2002

Unilateral versus bilateral sacral neuromodulation in patients with chronic voiding dysfunction.

PURPOSE: Bilateral sacral nerve neuromodulation has been proposed as a more effective treatment for chronic voiding dysfunction. However no comparison with the unilateral approach has been performed. We investigated the possible advantage of bilateral sacral neuromodulation. MATERIALS AND METHODS: In a prospective randomized crossover trial we investigated 33 patients who underwent bilateral implantation of a temporary test lead. Unilateral and bilateral test stimulation was continued for 4 to 6 days in all patients. Patients were randomly assigned to start with bilateral or unilateral stimulation. Between the stimulation episodes a 2-day washout interval was scheduled. Voiding diaries were completed at baseline and during the entire stimulation period. Sacral x-rays were taken to confirm lead positioning or possible migration after implantation and at the end of the test stimulation period. After 10 days the temporary leads were removed and voiding diaries were analyzed. RESULTS: After stimulation sacral x-ray revealed test lead migration in 8 patients, leaving 12 patients with urge incontinence and 13 with voiding difficulty and urinary retention available for review. A statistically significant improvement in voiding parameters was seen during the test stimulation period. However no statistically significant improvement was seen due to bilateral stimulation compared to unilateral stimulation. Two patients with urinary retention only started voiding to completion during bilateral stimulation. CONCLUSIONS: Bilateral is in general not superior to unilateral sacral neuromodulation. However, in some individuals bilateral stimulation may be more effective in relieving symptoms. Therefore, if unilateral percutaneous nerve evaluation fails, a bilateral test should be considered.

Adult↗
PubMed1991

Occupational health and the environment in an urban slum in India.

The Indo-Dutch Environmental & Sanitary Engineering Project under the Ganga action Plan in Kanpur and Mirzapur is being executed within the Indo-Dutch bilateral development cooperation framework. The project aims to integrate physical, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme to facilitate the transfer of new technologies and improvement of operation and maintenance of the new facilities. The project is also aimed at the improvement of the living conditions of the population, by installing drinking water and drainage systems. A socio-economic unit in the project supports the technical interventions by enhancing the community to participate in project activities. The Occupational Health Programme in Jajmau, an industrial slum of Kanpur, aims to improve the working conditions of tannery workers. Four hundred and ninety-seven tannery workers and 80 employees not engaged in leather work, from 20 tanneries, were interviewed and underwent physical examination. The mean age of tannery workers was 32 years, about half of them recently migrated to Kanpur. The majority of the workers are illiterate, have temporary jobs and 85% have a monthly income between 300 and 600 Rs. Occupational morbidity was 28.2%. Regular meetings with tannery owners, the training of tannery workers in first aid, and support for the installation of safety and health councils in tanneries are the main programme activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Expandable metallic stent placement in patients with benign esophageal strictures: results of long-term follow-up.

PURPOSE: To evaluate the long-term effectiveness of expandable esophageal metallic stents in benign esophageal strictures. MATERIALS AND METHODS: The authors performed long-term follow-up of 14 expandable metallic stents in 12 patients (aged 16-72 years) with benign esophageal strictures. All 12 patients had initially undergone placement of one stent; two patients received an additional stent because of recurrent dysphagia. RESULTS: No procedural complications occurred. Delayed complications occurred in all patients. New strictures formed in six stents (five patients), migration occurred in seven stents (six patients), and both migration and formation of new strictures occurred in one stent (one patient). New stricture formation caused recurrence of dysphagia and necessitated further treatment. Three of four stents that migrated within 2 months after placement but none of the four stents that migrated more than 2 months after placement caused recurrence of dysphagia. Six patients died of unrelated causes 6-20 months after stent placement. The remaining six patients are still alive 24-48 (mean, 35) months after stent placement. CONCLUSION: The long-term effectiveness of expandable metallic stents in benign esophageal strictures is not encouraging because of the high delayed-complication rate. That the patients with migration showed improvement of dysphagia, however, may warrant further investigation of temporary placement of a retrievable covered stent.

Adolescent↗
PubMed1997

Acute pancreatitis and microcrystals. Importance of the bile collection and biochemical parameters.

For a substantial number of patients with acute pancreatitis, no recognizable causes can be identified and such cases are called "idiopathic". With the introduction of duodenal bile collection for microscopic examination, it became possible to detect minor constituents of the bile, such as cholesterol and/or calcium bilirrubinate crystals. The mechanism by which crystals produce pancreatitis seems to be related to migration of aggregate crystals through the papilla, inducing papillary trauma or temporary impaction which can cause a biliopancreatic reflux. We now report a series of 45 patients with acute pancreatitis idiopathic, 120 with gallstones and 22 alcoholic. Of the patients with idiopathic pancreatitis whom we studied by biliary drainages, 22 were found to have abnormal drainages (MC+) (20 cholesterol crystals and 2 calcium bilirrubinate), 9 patients had more than 10 crystals per slide. The microcrystals positive (MC+) group had significantly higher values for AST (69.8 +/- 1.7) (mean +/- SEM), ALT (123.3 +/- 28.1), FA (252 +/- 28.1), G-GT (144.6 +/- 26.7) and BT (1.83 +/- 0.37) than the microcrystals negative group: AST (19.6 +/- 2.5), ALT (28.3 +/- 5.8), FA (170.5 +/- 15.1), G-GT (54.3 +/- 10.7) and BT (0.76 +/- 0.09). The more 10 crystals group had higher values (AST: 82.0 +/- 29.1, ALT: 143.1 +/- 43.5, FA: 294.8 +/- 57.2, G-GT: 171.8 +/- 38.4, BT: 2.61 +/- 0.82) than in the microcrystals negative group. We concluded that in the absence of other overt causes, the presence of crystals in bile of patients with pancreatitis justifies etiology. The number is not important.

Acute Disease↗
PubMedDate not supplied

Mechanisms of endosseous integration.

UNLABELLED: Although the clinical term "osseointegration" describes the anchorage of endosseous implants to withstand functional loading, it provides no insight into the mechanisms of bony healing around such implants. Nevertheless, an understanding of the sequence of bone healing events around endosseous implants is believed to be critical in developing biologic design criteria for implant surfaces. RESULTS AND DISCUSSION: This discussion paper shows that peri-implant bone healing, which results in contact osteogenesis (bone growth on the implant surface), can be phenomenologically subdivided into three distinct phases that can be addressed experimentally. The first, osteoconduction, relies on the migration of differentiating osteogenic cells to the implant surface, through a temporary connective tissue scaffold. Anchorage of this scaffold to the implant surface is a function of implant surface design. The second, de novo bone formation, results in a mineralized interfacial matrix, equivalent to that seen in cement lines in natural bone tissue, being laid down on the implant surface. Implant surface topography will determine if the interfacial bone formed is bonded to the implant. A third tissue response, that of bone remodeling, will also, at discrete sites, create a bone-implant interface comprising de novo bone formation. CONCLUSION: Treatment outcomes in dental implantology will be critically dependent on implant surface designs that optimize the biologic response during each of these three distinct integration mechanisms.

Animals↗
PubMed1997

[Percutaneous occlusion of small patent ductus arteriosus with detachable Gianturco spring coils. Preliminary results].

INTRODUCTION: Botallo's duct occlusion with Gianturco coils is effective in the fistulas with max. diameter of 3.3 mm. The insertion technique does not permit to control coil positioning inside the fistula and the coil itself may migrate to the pulmonary artery. We report our experience with a new system of temporary hookup of the coil proximal end to a metal thread (Cook device) which permits to change the position of the coil or to replace it. MATERIALS AND METHODS: We treated 6 patients with persistence of Botallo's duct (O: 2-3.5 mm, mean: 2.9 mm). The duct was occluded in 5/6 patients. The coil migrated to the pulmonary artery in a case where the hookup system permitted to retrieve and then replace it with a bigger coil which was also retrieved because it was too big for the small aorta. No complications were observed. RESULTS: Follow-up chest films at 24 hours showed coil stability and color Doppler US confirmed the occlusion. The patients were discharged after 24 hours. The follow-up at 6 months confirmed the procedure success. CONCLUSIONS: The hookup system was effective to control coil positioning and to extract and replace the coils. The effectiveness of this occlusion technique would be improved if a wider range of coil sizes and types were available.

Adolescent↗