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At least 523 records · Page 29Linked to original sources

Pseudoislet vascularization. Induction of diaphragm-fenestrated endothelia from the hepatic sinusoids.

The avascular islet tissue preparation, the pseudoislet, was transplanted into the liver of streptozotocin diabetic rats. The vascularization of the islet tissue was studied ultrastructurally over a 2-week period. At 2 days, proliferations of fibroblast-like cells and large amounts of collagen fibers were present at the periphery of grafts. By 7 days, vascular buds were present at the edge of the graft and invaginating into the islet tissue. At this time, diaphragmed fenestrae were present in the endothelial cells of these forming vessels and they were surrounded by a thin continuous basal lamina. By 12 to 14 days, vascularization was complete as determined by the presence of perfused vessels. At this time the mural architecture of the capillary endothelium was identical to that found in pancreatic islets in situ, i.e., diaphragmed fenestrae, transendothelial channels, and a continuous basal lamina. This contrasted sharply with normal hepatic sinusoidal endothelium which has larger open fenestrae, no channels, and a discontinuous or absent basal lamina. In animals that had been labeled with colloidal carbon before pseudoislet transplantation, the fenestrated endothelium in the grafts contained carbon-filled phagocytic vacuoles indicating the hepatic origin of these cells. Also present at this time was a change in the hepatic sinusoids near the graft sites to a near continuous endothelium. This study demonstrates that isolated avascular adult islet cells are capable of inducing a diaphragm-fenestrated endothelium.

Animals↗

[Personal experience with the treatment of pericardial effusion using pericardial fenestration].

The author discusses experience with treatment of pericardial exudates of different aetiology in 11 patients aged 5-54 years. In seven patients they performed fenestration and external drainage of the pericardial cavity from a subxyphoid approach and in four by a pleurocardial window from left-sided thoracotomy. They did not record any per or postoperative complications or deaths. The best surgical approach, in particular in patients with a pericardial exudate and a poor general condition is pericardial fenestration with external drainage from a subxyphoid approach.

Adolescent↗

[Percutaneous partial diskectomy in the dog--an alternative to surgical disk fenestration].

A new, technically simple operation method for the fenestration of disks is described which was performed successfully on six experimental dogs on the thoracolumbar disks and did not stress them very much. A percutaneous partial diskectomy (PPD) of the anulus fibrosus and the nucleus pulposus with a bone drill (diameter 5 mm) is performed. The extracted cylinder bone allows a histological judgement of the disci intervertebrales. This method was applied to 10 animal patients with discopathia, and it showed that evidently PPD is a good alternative to the conventional thoracolumbar disk surgery (dorsolateral fenestration). Besides the technical simplicity of this method its advantage is a quicker practicability and less operative stress of the patient.

Animals↗

[Saccular aneurysm arising from the basilar artery fenestration: a case report].

This patient, 29-year-old female, had an attack of subarachnoid hemorrhage. On admission a cerebral angiogram showed a saccular aneurysm arising from the proximal origin of the fenestrated basilar artery (Fig. 1). The aneurysm was clipped successfully with two steps under a right retromastoidal suboccipital craniectomy (Fig. 2). Association of the fenestrated basilar artery and saccular aneurysm is rare. To our knowledge, 9 cases have been found in the literature and only 4 cases were operated. The authors discussed the pathogenesis and treatment of such aneurysms.

Adult↗

Mesangial fenestrations, sieving, filtration, and flow.

Small tracers in the circulation enter the rat mesangium rapidly and in large amounts that indicate a sizable plasma flow into the mesangium. Entrance is effected through mesangial fenestrations with a mean width in scanning electron microscopy of 376 A, a size similar to fenestrations in peripheral glomerular capillary walls. This is considerably smaller than the mean size of 678 A found with transmission electron microscopy, but the difference is probably due largely to the anionic surface coat on endothelial cells. Measurements of asymmetric thorium dioxide particles show that smaller ones with a mean length of 315 A enter the mesangium preferentially and that larger particles with a mean length of 405 A are partially restricted, supporting the idea that the measured width in scanning electron microscopy is close to the actual width in vivo. Fluid flow into the mesangium requires fluid flow out. The appearance time and accumulation of tracers suggest the following exit paths of flow from the mesangium: through the overlying epithelium into the urinary space contributing to glomerular filtration and concentrating large tracers beneath the basement membrane in the paramesangial region, into the efferent glomerular capillaries after tracers have been filtered out by the fibrillar matrix, and through the hilus into the juxtaglomerular apparatus (quantitatively small).

Animals↗

[A case of giant aneurysm associated with vertebral fenestration (author's transl)].

A case of giant aneurysm associated with vertebral fenestration was reported. A 18-year-old female had complained of visual disturbance of left eye for past 2 years without headache, nausea and vomiting. Neurological examinations revealed normal except for optic atrophy on the left side. Physiological examinations were normal. Skull plain films showed the small calcification at the left supraclinoid region. Left common carotid angiograms revealed a giant aneurysm at left internal carotid artery measuring 4 X 2 X 2 cm in size, and left middle cerebral artery was poorly visualized. Vertebral angiograms showed the fenestration at left craniospinal junction. Computerized tomograms showed a round, granular high density lesion, and this lesion was clearly homogenously enhanced by contrast medium. It was considered that the direct surgery to this aneurysm might be impossible, because the neck of the aneurysm was located at extradural portion. Ligation of her common carotid artery was performed with Selverstone clamp. Her postoperative course was uneventful, and the postoperative angiograms revealed the reduction of the size of aneurysm. The etiological hypotheses of these cerebral vascular anomalies were briefly discussed.

Adolescent↗

Reconstruction of the facial fenestration in the Caldwell-Luc maxillary sinus operation.

The result of the inadvoidable removal of bone in the canine fossa during antral fenestration is a large bone defect. Scar tissue grows across this defect and sometimes obliterates and interferes with the antral physiology. This paper presents our experience with the reconstruction of the defect by means of the osteotomised canine fossa bone with adhering soft tissues. In this way the antral volume remains unchanged and irritation of the infraorbital nerve often caused by the scar tissue of the facial fenestration as well as other pathological sequelae after the Caldwell-Luc operation are avoided.

Humans↗

Saccular aneurysm at the basilar artery fenestration.

The authors describe a 19-year-old patient who was presented with a subarachnoid hemorrhage and was found to have a saccular aneurysm arising at the proximal end of the fenestration of the basilar artery. Previously reported cases are reviewed. Stereoscopic magnification angiography facilitated the analysis of the three-dimensional-anatomical relationship between the aneurysm and its fenestrated parent artery.

Adult↗

Indications for vena caval fenestration.

A retrospective study of 20 patients who underwent vena caval fenestration showed that in 50% of the patients the procedure was done for prophylaxis and in 50% it was done for therapeutic reasons. After this procedure five patients had persistent leg swelling, two had deep venous thrombosis, two had pulmonary emboli and one died of a respiratory arrest. We recommend limiting the use of vena caval fenestration to those patients who have verified pulmonary embolism while adequately anticoagulated or patients who have pulmonary embolism and a major contraindication to anticoagulation.

Adult↗

[A simple alternative technic in the treatment of idiopathic hydrocele in adults: vaginal "fenestration"].

The author describes a new, simple technique for the treatment of idiopathic hydrocele according to a "fenestration" procedure designed to correct the imbalance of intravaginal hydrostatic exchanges. The operation consists of initially hemming separately the deep fibrous layer and the parietal leaflet of the tunica vaginalis to form the margins of the "window", which is then applied by its fibrous layer to the dartos, continuous with the subcutaneous connective tissue, a site of rich lymphatic drainage. In a series of 108 patients treated by this technique since September 1982, with a follow-up of 6 years, the anatomical and functional results were excellent in 98 cases (90.7%), moderate in 6 cases (5.5%) and poor in 4 cases (3.7%). Compared to classical techniques, the fenestrated opening of the tunica vaginalis with preservation of the tunica vaginalis and limited opening of the serosa, preserves the testicular support and the protective role of the serosa on the testis. Lastly, suture of the margins of the window to the dartos, by facilitating deep lymphatic drainage towards the superficial connective tissue, reconstitutes a physiological equilibrium in the constant exchanges of intravaginal serous fluids. Experience has demonstrated the anatomical and functional efficacy and reliability of this extremely simple procedure, which is essentially indicated in adult patients with idiopathic hydrocele and a healthy tunica vaginalis.

Adult↗

Treatment of fenestration and dehiscence bone defects around oral implants using the guided tissue regeneration technique: a prospective multicenter study.

Four clinical centers, using the Brånemark System and with personnel trained in the use of Gore-Tex Augmentation Material (GTAM), participated in a prospective study of 45 patients 18 to 83 years of age. A total of 55 implants were placed with membranes because of local bony defects (fenestration or dehiscence). Dehiscence and fenestration defects were evaluated as one group. The mean initial defect height was 4.7 mm (SD = 3.0). After healing, the remaining defect height was reduced to 1.1 mm (SD = 2.3). The decrease in surface exposure was significant. Complications were primarily attributed to exposure of six membranes during the early healing period. The cumulative survival rate was 84.7% in maxillae and 95.0% in mandibles after 2 years of follow-up. The surgical application of GTAM to produce bone in localized bony defects around oral implants seems to be a predictable method that may reduce the need for extensive augmentation surgery in patients with insufficient jaw bone volume.

Adolescent↗

[A simple alternative method in the treatment of idiopathic hydrocele in adults: vaginal "fenestration"].

The author describes a new, simple technique for the treatment of idiopathic hydrocele according to a "fenestration" procedure designed to correct the imbalance of intravaginal hydrostatic exchanges. The operation consists of initially hemming separately the deep fibrous layer and the parietal leaflet of the tunica vaginalis to form the margins of the "window", which is then applied by its fibrous layer to the dartos, continuous with the subcutaneous connective tissue, a site of rich lymphatic drainage. In a series of 108 patients treated by this technique since September 1982, with a follow-up of 6 years, the anatomical and functional results were excellent in 98 cases (90.7%), moderate in 6 cases (5.5%) and poor in 4 cases (3.7%). Compared to classical techniques, the fenestrated opening of the tunica vaginalis with preservation of the tunica vaginalis and limited opening of the serosa, preserves the testicular support and the protective role of the serosa on the testis. Lastly, suture of the margins of the window to the dartos, by facilitating deep lymphatic drainage towards the superficial connective tissue, reconstitutes a physiological equilibrium in the constant exchanges of intravaginal serous fluids. Experience has demonstrated the anatomical and functional efficacy and reliability of this extremely simple procedure, which is essentially indicated in adult patients with idiopathic hydrocele and a healthy tunica vaginalis.

Adolescent↗

Congenitally bicuspid aortic valves: study of a variant with fenestrated raphe.

OBJECTIVE: To illustrate and describe a variant of the congenitally bicuspid aortic valve (BAV) in the context of previous reports of the morphology of BAVs. SETTING: Retrospective review of surgically excised aortic valves at The University of Ottawa Heart Institute in Ottawa, Ontario. DESIGN AND PATIENTS: The clinical, echocardiographic and pathological features of 17 cases with a variant of BAV were examined from patients who had valve replacements performed in the period from January 1, 1986 to December 31, 1992. MAIN RESULTS: A total of 865 patients had native aortic valve replacements during the study period and 291 patients had BAVs. One hundred and eighty-one patients were male (62%) (mean age 60 years) and 110 were female (38%) (mean age 64 years). There were 17 BAVs (6%) where either: the raphe was fenestrated so that only a thin fibrous band (or bands) joined the valve cusp to aortic wall-type A valves (seven cases); or a similar fibrous band (or bands) was seen, but was associated with other usual appearing raphal tissue--type B valves (10 cases). These patients included 15 males (mean age 63 years) and two females (mean age 63 years); they presented with dyspnea and/or angina. Distinction of the number of cusps with this variant was incorrect in six of nine transthoracic echocardiograms, and three of four transesophageal echocardiograms. CONCLUSION: This variant of BAV, with fenestrated raphe, is not well described in the literature, is difficult to diagnose clinically and may present in unusual ways.

Aged↗

Laparoscopic hernia repair: use of a fenestrated PTFE graft with endo-clips.

A prospective study of 15 patients undergoing elective laparoscopic herniorrhaphy was performed using the introduction of a polytetrafluorethylene (PTFE, GORE-TEX) patch fenestrated around the edges to facilitate the use of an Endo-Clip applier. Patient tolerance was increased, and time lost from work was reduced. Two patients treated for prostatitis resumed sexual activity within the first 10 days with no recurrences or intra-abdominal infections. Fenestration of the PTFE patch was possible without fraying the material and without compromising the strength of the patch. The Endo-Clip applier secures the patch to the ligamentous structures. Initial cases were followed for 6 months.

Adult↗

[Transfemoral fenestration and stent implantation in aorto-iliac dissection].

Subacute left lower limb ischemia developed in a patient with aortic dissection. Angiography revealed a dissection of the aorta abdominalis and a severe stenosis of the left common iliac artery. The patient underwent successful percutaneous fenestration and intravascular stent placement. The patient is currently (4 month post-intervention) ambulating without any signs of the leg ischemia. Percutaneous balloon fenestration and, if necessary, stent placement should be considered as a treatment option and a alternative to surgery in selected cases.

Aortic Dissection↗

Studies on fenestral contraction in rat liver endothelial cells in culture.

Liver endothelial cells possess fenestrae, which are pores supported by a cytoskeleton ring composed of actin and myosin. Fenestrae are dynamic structures that can contract or dilate, although the mechanism for this phenomenon remains to be elucidated. Staining of actin and/or of myosin permitted measurement of fenestral diameter and area in cultured rat liver endothelial cells using digitized video-intensified fluorescence microscopy with image analysis. Within 1 minute of incubation with 0.1 micromol/L serotonin, fenestral diameter and area decreased by 24 +/- 5% and 56 +/- 7%, respectively. Contraction of fenestrae by serotonin was inhibited by chelation of extracellular Ca2+ with EGTA and by addition of Ca2+ channel blockers, such as dilthiazem and verapamil. The response of fenestrae to serotonin was mimicked by addition of a Ca2+ ionophore, A23187. Serotonin inhibited cAMP production, had no effect on inositol phosphate production, and activated phospholipase A2, causing release of arachidonic acid. These results suggest that contraction of fenestrae is associated with Ca2+ influx. In response to 0.1 micromol/serotonin, intracellular Ca2+ levels increased within 3 to 5 seconds from 150 nmol/L to >400 nmol/l followed by rapid phosphorylation of the 20-kd subunit of myosin light chain; both events dependent on extracellular Ca2+.

Animals↗

Burr hole neuroendoscopic fenestration of quadrigeminal cistern arachnoid cyst: technical case report.

Arachnoid cysts of the quadrigeminal cistern have been managed by cyst shunting and craniotomy with cyst fenestration. Two children are presented who underwent successful burr hole neuroendoscopic fenestration of symptomatic quadrigeminal plate cysts. The literature is reviewed with regard to the treatment of quadrigeminal arachnoid cysts, and the neuroendoscopic management of these cysts is described.

Adolescent↗

Vertebrobasilar junction aneurysms associated with fenestration: treatment with Guglielmi detachable coils.

Three patients with vertebrobasilar junction aneurysms and associated fenestration were treated with Guglielmi detachable coils. The structure and hemodynamics of fenestrations may account for their frequent association with aneurysms. The complex hemodynamics of these aneurysms requires evaluation of both vertebral arteries. One treatment complication occurred but resulted in no deficit. All patients have returned to normal activity and remain healthy at 14 to 46 months.

Aged↗