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At least 469 records · Page 26Linked to original sources
PubMed1992

Serial assessment of denervated but viable myocardium following acute myocardial infarction in dogs using iodine-123 metaiodobenzylguanidine and thallium-201 chloride myocardial single photon emission tomography.

Iodine-123 metaiodobenzylguanidine (mIBG) is taken up by sympathetic nerve endings, allowing scintigraphic imaging of myocardial sympathetic innervation. We investigated the denervated but viable canine myocardium after acute myocardial infarction by serial mIBG and thallium-201 chloride (201TlCl) single photon emission tomography (SPET). In 12 dogs, acute myocardial infarction was produced by ligation of the left circumflex coronary artery. Images of mIBG and thallium SPET were obtained 6 h, 1, 4 and 6 weeks later. The defect size was calculated in percentage points from short axial views, and the 123I-mIBG/201TlCl ratio was determined. The uptake ratio was high at 1 week but gradually decreased. Three dogs were killed at each time point, and tissue samples were obtained from infarcted (both 201TlCl and 123I-mIBG defects), peri-infarcted (123I-mIBG defect and 201TlCl normal) and normal myocardium (both mIBG and 201TlCl normal). The changes in tissue content of noradrenaline in these lesions were measured. Noradrenaline tissue content gradually recovered in the peri-infarcted area. However, no recovery was noted in the infarcted area at 6 weeks. We conclude that sympathetic denervation and re-innervation occur following acute myocardial infarction, and the denervated but viable myocardium could be detected non-invasively by combined mIBG and thallium SPET.

3-Iodobenzylguanidine↗
PubMed1999

Malakoplakia of the caecum in a kidney-transplant recipient: presentation as acute tumoral perforation and fatal outcome.

Malakoplakia is a rare pseudotumoral inflammatory disease known to affect immunocompromised subjects, mainly with a history of recurrent Escherichia coli infection. The urinary tract is the most frequent site of the disease, although all organs can be involved. In the present article, we report a case of malakoplakia of the caecum, that developed in a 52-year-old man, who had received a kidney transplant 9 years before and had a history of recurrent E. coli urinary tract infections. Malakoplakia presented as acute intestinal perforation, and, despite aggressive surgical and medical management, disease progressed toward a fatal outcome due to sepsis and multiple organ failure 9 months later. A defect in the macrophagic activity was demonstrated.

Bacteremia↗
PubMed2004

Use of 99mTc-sestamibi gated SPECT to assess the influence of anterograde flow before primary coronary angioplasty on tissue salvage and functional recovery in acute myocardial infarction.

PURPOSE: Preserved thrombolysis in myocardial infarction (TIMI) flow before percutaneous coronary intervention (PCI) in acute myocardial infarction is related to improved outcome. Gated single-photon emission computed tomography (SPECT) allows the simultaneous assessment of left ventricular perfusion and function. We evaluated the initial risk area and subsequent evolution of perfusion and function according to TIMI flow before successful primary PCI. METHODS: In 36 patients, treated with abciximab, primary PCI and stenting, 99mTc-sestamibi was injected before PCI and gated SPECT acquired thereafter. Gated SPECT was repeated 7 and 30 days later. Perfusion defect, wall motion score index, left ventricular ejection fraction and volumes were examined. RESULTS: Before PCI, 14 patients (group A) showed TIMI flow 2-3 and 22 (group B) TIMI flow 0-1, but no differences in clinical variables, initial risk area, wall motion score, ejection fraction or volumes. Perfusion defect was smaller in group A at 7 (9%+/-11% vs 19%+/-14%, p<0.02) and 30 days (7%+/-7% vs 16%+/-12%, p<0.02) and the salvage index was higher at 30 days (77%+/-22% vs 55%+/-28%, p<0.02). Wall motion score was lower in group A at 30 days (p<0.05). Ejection fraction significantly improved in both groups at 7 and 30 days. End-diastolic volume showed a trend towards a reduction in group A, whilst it was significantly increased in group B. Conversely, end-systolic volume was significantly decreased in group A but remained unchanged in group B. CONCLUSION: In the setting of optimal myocardial reperfusion for myocardial infarction, preserved TIMI flow before PCI does not limit the initial risk area but it does improve myocardial salvage and functional recovery.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Single coronary artery with aortic regurgitation.

An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively.

Aortic Valve Insufficiency↗
PubMed2006

Sex and congenital diaphragmatic hernia.

BACKGROUND AND PURPOSE: Human studies note sex reversal syndromes and sex difference(s) in the incidence of congenital diaphragmatic hernia (CDH). Epidemiology surveys record a higher incidence of CDH in females, whilst other reports cite a higher frequency in males. Nitrofen, a teratogen, produces experimental CDH. This agent is speculated to interfere with retinoid acid-steroid signalling pathways and may also be linked with sexual differentiation. This study was designed therefore to test the hypothesis that nitrofen may influence sexual phenotype and frequency of CDH. METHODS: Time mated Sprague Dawley rats were dosed with nitrofen at day 9.5 to generate predominantly left sided CDH. Fetuses were delivered by caesarean section on days 20 or 21 of gestation (term=day 22). External genitalia were examined to define external genital phenotype. The abdominal cavity was opened and the genito-urinary system carefully examined. The internal genital organs were assigned a phenotype and findings correlated with external appearances. The diaphragm of each fetus was studied for the absence or presence of CDH and the laterality of defect recorded. Controls (non nitrofen fed) were used for all comparative analysis. RESULTS: Control (n=600) and nitrofen exposed offspring (n=504) had equal frequencies of males and females. CDH occurred with similar incidence in male and female nitrofen treated pups. In all nitrofen exposed fetuses and normal controls, internal and external genitalia concorded without evidence of significant genital tract malformations or intersex states. CONCLUSIONS: Prenatal nitrofen exposure is not associated with significant gender differences (or prenatal loss) in the risk of CDH. Genital tract malformations do not appear to accompany CDH in the nitrofen model.

Animals↗
PubMed1999

Vulva formation in Pristionchus pacificus relies on continuous gonadal induction.

One of the best known features of vulva development in Caenorhabditis elegans is the induction of vulval precursor cells by the gonadal anchor cell. Induction is crucial for the initiation of pattern formation within the C. elegans vulva equivalence group, and it is therefore surprising to find that this aspect of vulva formation, in particular, varies greatly among nematodes. In some species which form vulvae in the posterior body region, no gonadal signal is necessary for vulva induction. In other nematodes, such as Panagrolaimus, Oscheius, and Rhabditella, vulva formation depends on two temporally distinct gonadal inductions which specify the different cell fates. Here we report our analysis of vulva induction in Pristionchus pacificus, a species which has recently been used as a genetic system to analyze the evolution of vulva development. Cell ablation studies in P. pacificus show that another mode of vulva induction exists. P. pacificus vulva formation depends on a continuous gonadal induction that starts several hours after hatching and continues until the birth of the anchor cell, some 20 h later. Mutations defective in gonadal induction result in the absence of vulva differentiation, suggesting that only one signaling system is involved in the gonadal-epidermal interaction. This new mode adds further to the great variety of gonadal inductions among nematode species.

Animals↗
PubMed2002

An unusual cause of delayed presentation of laparoscopic common bile duct injury.

We describe an unusual case of a laparoscopic common bile duct (CBD) injury that presented with cholangitis 2 years after an apparently uneventful laparoscopic cholecystectomy. Preoperative ultrasound and endoscopic retrograde cholangiography suggested choledocholithiasis, showing proximal and intrahepatic duct dilatation with an inability to relieve the obstruction. At surgery, a lateral injury of the CBD wall with partial wall loss was found, adherent to an amorphous pigmented mass with the appearance of a knitted fabric causing CBD obstruction. The CBD was successfully reconstructed with a Roux-en-Y end-to-side hepaticojejunostomy, where the end of the Roux loop was anastomosed to the lateral CBD defect.

Aged↗
PubMed1994

Significance of anterior ST depression in inferior wall acute myocardial infarction.

Early tomographic myocardial perfusion imaging with technetium-99m sestamibi was performed during inferior wall acute myocardial infarction to determine the relation between the amount and location of myocardium at risk and the presence or absence or anterior ST depression. The total size of the acute perfusion defect and its lateral and septal borders were measured in 29 consecutive patients who were admitted with > 30 minutes of chest pain and acute inferior ST elevation on their initial electrocardiogram. The 22 patients with anterior ST depression had significantly more left ventricular myocardium at risk than the 19 patients who did not have anterior ST depression (23 +/- 2% of the left ventricle vs 15 +/- 1%, p = 0.008). All 8 patients with > 25% of the left ventricle at risk had anterior ST depression. Patients with anterior ST depression had a significantly greater lateral extent of the acute perfusion defect (49 degrees +/- 8 degrees from the midinferior wall vs 23 degrees +/- 7 degrees, p = 0.002). There was no difference in the septal border of the perfusion defect between patients with and without anterior ST depression (-44 degrees +/- 4 degrees vs -46 degrees +/- 7 degrees, p = NS). No patient had a measurable anterior perfusion defect. Although there is considerable overlap between groups with and without anterior ST depression, anterior ST depression is a simple and readily available indicator of myocardium at risk in inferior wall acute myocardial infarction.

Adult↗
PubMed1993

Refinements in the axial frontonasal flap.

The frontonasal flap is a useful flap for medial and lateral tip defects of the nose. It can be used as a random rotation flap or as an axial flap. This paper describes modifications to the original designs of these flaps, with improvements in the final scar.

Cicatrix↗
PubMed1992

Intraoperative assessment of blood flow to strangulated stomach by pulse oximetry.

A pulse oximeter was used to detect safe margins for resection of a strangulated stomach. The sensor probe was placed intraoperatively on various portions of the stomach, which herniated through a left lateral diaphragmatic defect. Failure to detect blood flow by this device in equivocally compromised tissue helped in the assessment of safe viable margins for resection.

Female↗
PubMed2006

Staging and surgical approaches in large juvenile angiofibroma--study of 95 cases.

INTRODUCTION: Surgery has been the treatment of choice for juvenile nasopharyngeal angiofibroma (JNA) and selection of proper surgical approach depends primarily upon the extensions of the tumor. Minimal external deformity/surgical scar without affecting growth pattern of facial skeleton of patient along with extensions of JNA were the basis of selecting surgical approach in present study. MATERIAL AND METHODS: The medical records of 95 patients with histologically proven large JNA who underwent treatment in our institution between 1992 and 2002 were reviewed retrospectively. Inclusion criterion-Stage II, III, IV JNA, minimum available follow up of 2 years. Exclusion criterion-Stage I JNA, follow up of less than 2 years. Lazy S incision was used and combined transmaxillary and transpalatal removal of angiofibroma was done in most of the cases. RESULTS: Complete removal of JNA was achieved in 78 (82%) cases in single surgery. Residual tumor was found in 17 (18%) cases. CONCLUSIONS: Infratemporal, pterygopalatine, orbital and intracranial extensions of JNA (Stage IIIa and IIIb) can be removed by combined transpalatal and transmaxillary approach by Lazy S incision without producing any facial asymmetry or cosmetic defect. Conservative lateral infratemporal approach (type D1 approach) is required in very large lateral extensions or where JNA is extending intracranially through foramen ovale. Staged fronto-temporal craniotomy should be done in Stage IVa tumors (large intracranial extensions). In Stage IVb tumors (invading cavernous sinus), usually residual tumor remains which should be followed subsequently.

Angiofibroma↗
PubMed2006

Adaquate fixation of plates for stability during mandibular reconstruction.

PURPOSE: To determine the most appropriate plate fixation for dispersing the stress around screws in mandibular reconstruction. MATERIAL AND METHODS: Forty-eight three-dimensional reconstructed mandibular models with Central (C) or right Lateral (L) defects were created and divided into three groups, fixed with: (1) two screws on each side, (2) three screws on the left side with the third (middle one) located distally, or (3) three screws on the left side with the third (middle one) located proximally. A 300N vertical load was applied to the left molar region. The maximum stress was calculated using a finite element method and statistically evaluated. RESULTS: Stress was concentrated around the screw at the distal end of the mandibular halves on the loaded side ('crucial screw'). For the C defect, stress concentrated around the 'crucial screw' was greater when there were only two screws for fixation (20.55MPa) than when there were three screws (16.17MPa; p=0.022). No significant difference was found between the two groups with three screws for fixation. For the L defect on the other hand, stress on the 'crucial screw' was relatively greater when there were three screws for fixation (18.9MPa) than when there were only two screws for (12.83MPa; p=0.051). No significant difference was found between the two groups with three screws for fixation. As for the reconstruction plate, the stresses on the plates were not different among the various screw groups for fixation nor among the C and L defects. CONCLUSION: This paradoxical result is explained by plate bowing. Thus in large defects screw positions should take into consideration the potential for plate bowing.

Bite Force↗
PubMedDate not supplied

Radial forearm free flap for coverage of postoperative lateral heel wounds after open reduction and internal fixation of the calcaneus.

For intraarticular calcaneus fractures, open reduction and internal fixation has become commonplace for the reduction of morbidity of postinjury arthritis. Despite adequate surgical results, there are often associated postoperative wound complications. The purpose of this study was to describe a unique application of the radial forearm free flap for coverage of lateral postoperative heel defects seen after calcaneal fixation. Seven lateral heel wounds after open reduction of calcaneal fractures in 6 patients were covered with radial forearm free flaps. The technique used involved passage of the pedicle of the laterally placed flap anteriorly to the Achilles tendon so that it can be anastomosed to the posterior tibial artery. Flap application was 100% successful, with good functional and cosmetic results in all patients. The radial forearm free flap provides a quick, reliable, and easily harvested source of coverage for lateral heel wounds seen after open reduction and internal fixation of the calcaneus. Tunneling of the flap pedicle anterior to the Achilles tendon is simple and provides the additional advantages of access to reliable vessels, reduced scarring, and avoidance of further wound problems often seen with incisions used to access the anterior tibial artery.

Adult↗
PubMed2005

Foxg1 is required for specification of ventral telencephalon and region-specific regulation of dorsal telencephalic precursor proliferation and apoptosis.

Null mutation of the Foxg1 gene causes hypoplasia of the mouse telencephalon and loss of ventral telencephalic structures. We show that a crucial early requirement for Foxg1 is in the induction of ventral cell fate in the telencephalon. To study later proliferative defects, we have adapted an iododeoxyuridine and bromodeoxyuridine double labeling protocol for use in the developing embryo, which allows estimation of cell cycle kinetics in a single specimen. This technique is used to demonstrate that the cell cycle is prematurely lengthened in the Foxg1-null telencephalon. These defects are first apparent at embryonic day 10.5 (E10.5) and are most severe in the rostral telencephalon. We show that apoptosis is also reduced in the same rostral domain. These defects correspond temporally and spatially with a dramatic reduction in expression of the potent signaling molecule Fgf8. We also show that in the absence of Foxg1 an excess of neurons is produced from E11.5, depleting the progenitor pool and limiting the growth of the Foxg1(-/-) telencephalon. The increase in neurogenic division coincides with an increase in BMP signaling, as detected by immunohistochemistry for phosphorylated smad-1, -5, and -8. This study reinforces Foxg1's position as a major regulator of telencephalic neurogenesis and supports the idea that Foxg1 controls precursor proliferation via regulation of Fgf signaling and differentiation via regulation of Bmp signaling.

Animals↗
PubMed2004

The mechanism of sister chromatid cohesion.

Each of our cells inherit their genetic information in the form of chromosomes from a mother cell. In order that we obtain the full genetic complement, cells need to ensure that replicated chromosomes are accurately split and distributed during cell division. Mistakes in this process lead to aneuploidies, cells with supernumerous or missing chromosomes. Most aneuploid human embryos are not viable, and if they are, they develop severe birth defects. Aneuploidies later in human life are frequently found associated with the development of malignant cancer. DNA replication during S-phase is linked to segregation of the sister copies in mitosis by sister chromatid cohesion. A chromosomal protein complex, cohesin, holds replicated sister DNA strands together after their synthesis. This allows pairs of replication products to be recognised by the spindle apparatus in mitosis for segregation into opposite direction. At anaphase onset, cohesin is destroyed by a site-specific protease, separase. Here I review what we have learned about the molecular mechanism of sister chromatid cohesion. Cohesin forms a large proteinaceous ring that may hold sister chromatids by encircling and topological trapping. To understand how cohesin links newly synthesised replication products, biochemical assays to study the enzymology of cohesin will be required.

Animals↗
PubMed2006

Unilateral cervical cancer in a patient with cervix duplex.

BACKGROUND: Although uterine anomalies are uncommon, gynecologists must be aware of the anatomical challenges that may be encountered from these anomalies. Cervical cancer in the context of a mullerian lateral fusion defect is rare. CASE: A case of a unilateral IB1 squamous cell carcinoma of the cervix in the setting of a complete uterovaginal septum and cervix duplex is described. CONCLUSION: Uterine anomalies compound diagnostic difficulty of routine pathology. Thorough examination and evaluation are crucial for timely diagnosis and treatment. Genital tract duplication, although rare, should always be considered.

Adult↗
PubMed1992

Canalization failure of the müllerian tract.

A patient is described with canalization failure of the müllerian system. This patient presented with primary amenorrhea and absence of the vagina. At the time of laparotomy, a uterus of normal size and shape was found with two small areas of canalization. This syndrome, associated with absence of the vagina, appears to result from a defect occurring later in development than does classical müllerian aplasia. Pathological examination of the patient's uterus supports the tenant that canalization begins after fusion and at various places along the line of fusion.

Adolescent↗