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At least 577 records · Page 32Linked to original sources

Ruptured vertebrobasilar junction aneurysm associated with basilar artery fenestration.

A case of a ruptured saccular aneurysm arising from the proximal portion of a partially duplicated basilar artery in a 36-year-old woman is reported. CT and lumbar puncture confirmed subarachnoid haemorrhage. Cerebral angiography detected a vertebrobasilar junction aneurysm associated with basilar artery fenestration. The patient underwent successful clipping and coating of the aneurysm by a right lateral suboccipital osteoclastic approach. Embryological development, pathogenesis, diagnostic and therapeutic difficulties of this vascular malformation are discussed in this report.

Adult↗

Localization of specific binding sites for 125I-TGF-beta1 to fenestrated endothelium in bone and anastomosing capillary networks in enamel organ suggests a role for TGF-beta1 in angiogenesis.

Previous studies have shown endothelial cells to be a major target for endocrine TGF-beta in several soft tissues in the normal growing rat. The potent effect of TGF-beta1 on bone formation prompted us to analyze in detail the localization of specific binding sites for endocrine TGF-beta in hard tissues. At 2.5 minutes after injection of 125I-TGF-beta1, specific binding, as demonstrated by quantitative radioautography, was localized to fenestrated endothelium participating in angiogenesis in the vascular invasion region of the growth plate in bone as well as to anatomizing capillary networks in the maturation zone of the enamel organ. At 15 minutes after injection, the bound ligand was internalized into endocytic vesicles of endothelial cells. In bone, quantitation revealed significant differences in receptor density between endothelia undergoing proliferation vs those in a state of elongation and anastomosis with neighboring endothelial cells. In the rat incisor, specific binding of 125I-TGF-beta1 to endothelium correlated with increased formation of anastomotic capillary networks. These studies identify differential specific binding sites of 125I-TGF-beta1 in angiogenically active endothelium, providing an important link between TGF-beta1, the endothelium, and hard tissue development.

3T3 Cells↗

Treatment of recurrent colonic pseudo-obstruction by endoscopic placement of a fenestrated overtube. Report of a case.

The case of a 73-year-old man who developed acute colonic pseudo-obstruction (Ogilvie's syndrome) following chemotherapy for lymphoma is reported. Cecal dilatation resolved after a single colonoscopic decompression. Following his next course of chemotherapy, colonic dilatation again developed. The recurrence was treated successfully by introducing a fenestrated colonoscopic overtube transanally for continuous decompression. The literature concerning acute, colonic pseudo-obstruction is reviewed. The colonoscopic overtube is a convenient and effective treatment for recurrent colonic distention.

Acute Disease↗

[Experimental studies in weakening the stability of the trochanter major by lateral fenestration].

A major disadvantage of the usual 130 degree angle plates when handling the fracture of the neck of the femur is the fact that the lateral corticalis of the femur is almost completely interrupted by the broad window at a biomechanical important and highly strained location. This often leads to the complications such as the breaking off of the greater trochanter or lack of stability etc. The experiment examines ten pairs of human femora for a decrease of stability, which results from the lateral fenestration for the osteosynthesis. One of the two bones out of a pair received a slit at a right angle concerning the axis of the femur, the other one a round hole. The slit was made into the proximal lateral femur as if preparing for the installation of a 130 degree angle plate. On the corresponding spot of the second bone a round hole was drilled. The remaining stability of the compact bone was measured by experimental pulling on the greater trochanter. Under the assumption that left and right femur have about the same stability, which was proven in one of the experiments, a significant disadvantage was found for the relatively wide slit.

Biomechanical Phenomena↗

Laparoscopic fenestration and modified marsupialization of posttraumatic splenic cysts using a harmonic scalpel.

In recent years, the advanced laparoscopic experience has revolutionized surgery and fostered the expansion of the indications for minimally invasive surgery in the diagnosis and treatment of all intra-abdominal pathology. Total splenectomy, which traditionally was the procedure of choice in the treatment of symptomatic nonparasitic splenic cysts, recently has been changed to a more conservative approach by many authors [1, 5, 9]. The conservative methods preserve immunologic function of the spleen and prevent the potentially fatal postsplenectomy sepsis complications [9]. We successfully performed laparoscopic fenestration and modified marsupialization of these cysts using a harmonic scalpel on two patients with symptomatic splenic psuedocysts.

Accidents, Traffic↗

Video-assisted thoracoscopic pericardial fenestration for tuberculous pericardial effusion.

A 72-year-old woman was admitted with chest discomfort and general fatigue. She was diagnosed as having cardiac tamponade with massive pericardial effusion. Percutaneous pericardiocentesis yielded bloody effusion. Tuberculous pericarditis was suspected owing to the adenosine deaminase level in this fluid. Video-assisted thoracoscopic pericardial fenestration (VATSPF) was performed for the diagnosis and treatment. Polymerase chain reaction detected Mycobacterium tuberculosis DNA in the pericardial tissues, confirming the diagnosis of tuberculous pericarditis. She received a combination of three-kind medication and anti-tuberculous regimen, and a follow-up check up for more than 2 years, exhibiting a good postoperative course. We conclude that VATSPF can be a useful procedure not only for diagnosis but for release of tuberculous pericarditis with cardiac tamponade and for prophylaxis of constrictive pericarditis.

Aged↗

Protein-losing enteropathy after Fontan operation: resolution after baffle fenestration.

A 4-year-old child with hypoplastic left heart syndrome and a 6-year-old child with tricuspid atresia had both undergone staged reconstructive operations culminating in a Fontan operation. Peripheral edema, ascites, and hypoalbuminemia refractory to dietary manipulation and steroid therapy developed in both patients. After hemodynamic assessment, each child underwent surgical creation of a 4.8-mm fenestration in the previously placed baffle that separated the systemic venous pathway from the pulmonary venous atrium. Peripheral edema and ascites promptly resolved and serum protein levels normalized within 2 weeks after operation. Systemic arterial saturation is 86% in each child, and both children remain clinically well with no evidence of protein-losing enteropathy on normal diets and without specific medical therapy.

Ascites↗

Fenestrated capillaries in subarachnoid space in the caudal spinal cord of the premature rat: an electron microscopic observation.

The fine structure of the conus medullaris of the spinal cord and surrounding structures were studied in postnatal developing rats, with special attention being paid to the vasculature. The most striking finding was the presence of fenestrae in the capillary endothelium of the subarachnoid space. These structures were not obvious in adult rats. The fenestrated capillaries may influence fluid dynamics in the subarachnoid space of the spinal cord at the level of the conus medullaris, during early stage of postnatal development.

Animals↗

Multiple arterial fenestrations, multiple aneurysms, and an arteriovenous malformation in a patient with subarachnoid hemorrhage.

We report the case of a 49-year-old, right-handed man with multiple vascular pathologies, including a fenestrated anterior communicating artery and middle cerebral artery, an aneurysm of the anterior communicating artery, multiple aneurysms of the middle cerebral artery, and an arteriovenous malformation. Diagnoses were made through computed tomography, cerebral angiography, magnetic resonance imaging, and intraoperative dissection. The lesions were managed surgically in stages with satisfactory results. Congenital and hemodynamic factors may have combined to manifest in the anomalies present in this unique case. We believe that no similar combination of vascular pathology has been reported previously.

Humans↗

Unilateral hydrocephalus resulting from occlusion of foramen of Monro: a new procedure in the treatment: stereotactic fenestration of the septum pellucidum.

Obstruction at the foramen of Monro resulting in unilateral hydrocephalus is an uncommon entity that may be caused by a wide range of lesions including tumors, vascular malformations, and inflammatory conditions. A case of unilateral hydrocephalus secondary to congenital atresia of the foramen of Monro treated with stereotactic fenestration of the septum pellucidum is presented.

Cerebral Ventricles↗

Blade-deviated fenestrated clips for anterior communicating artery aneurysms.

Blade-deviated fenestrated clips developed by one of the authors were applied very successfully in 15 cases of A Com A aneurysms which corresponded to 32% of the aneurysms upon which were operated. Of the 15, 13 cases were projected superiorly, which is the most difficult and hazardous type if ruptured at the neck. The characteristic feature of the clip is the lateral deviation of occluding blades. The superiorly projecting type A Com A aneurysm is located posterolateral to the A Com A in the operative field, and the clips were extremely useful in the aneurysms in providing safer and more exact occlusion via parallel closure of the A Com A or the aneurysm neck.

Adult↗

Fenestration patterns in endothelial cells of rat liver sinusoids.

Endothelial fenestrae of both zone 1 and zone 3 acinar liver sinusoids have been studied in rats by an interactive analysis of scanning electron microscopical images. Two fenestration patterns have been recognized in the endothelial cells on the basis of local variation in size, distribution and clustering of pores in each acinar zone. Our data indicate that both the number of fenestrae per square micrometer of endothelial surface and the mean diameter of fenestrae are significantly larger in zone 3 than in zone 1. The number of sieve plates is about 1.74 times larger in zone 3 than in zone 1, and the number of fenestrae per plate in zone 3 is nearly twice that in zone 1. Two different classes of fenestrae have been considered: clustered pores, which prevail in zone 3 and have a mean diameter smaller than the other pores, and free pores, which prevail in zone 1 and are bigger.

Animals↗

Primary endovascular repair of juxtarenal aneurysms with fenestrated endovascular grafting.

PURPOSE: To evaluate outcomes of an endovascular graft incorporating the visceral aortic segment with graft material in the setting of juxtarenal aneurysms. MATERIALS AND METHODS: A prospective analysis of patients undergoing implantation of an endovascular device with graft material proximal to the renal arteries was conducted. All patients were deemed unacceptable candidates for open surgical repair and had proximal neck length=<10 mm, or =<15 mm with a compromising morphology (funnel or thrombus). Fenestrations were customized to accommodate aortic branch anatomy based upon CT and intravascular ultrasound data. Selective visceral ostia were treated with balloon expandable stents following endograft deployment. All patients were evaluated with CT, duplex ultrasound, and abdominal radiograph at discharge, 1, 6, 12 and 24 months. RESULTS: A total of 32 patients were enrolled in the trial. Short proximal necks (3-10 mm) were present in 22, and 10 had necks 10-15 mm in length with concomitant angulation or thrombus compromising neck quality. Endograft design included bifurcated (30) and aortic tube (2) systems. A total of 83 visceral vessels were incorporated (mean of 2.6 per patient). These most commonly included both renal arteries and the SMA. All prostheses were implanted successfully without the acute loss of any visceral arteries. The mean follow-up was 9.2 months (range 0-24 months). One patient died within 30 days of device implantation and hypogastric bypass following the development of aspiration pneumonia. Three early (<30 days) and three late secondary interventions were performed. The 30-day endoleak rate was 6.5%. The aneurysm sac decreased greater than 5 mm in 58% of patients at 6 months and in 75% of patients at 12 months. One patient, with a persistent type II endoleak had 5 mm of sac growth over 12 months. Six patients had transient or permanent elevation of serum creatinine (>30% from baseline), with one requiring hemodialysis. Of the 83 vessels incorporated, three late stenoses (all successfully treated with an endovascular approach) and two renal occlusions were detected during follow-up. Three patients died of unrelated causes during the follow-up period. CONCLUSIONS: The placement of endovascular prostheses with graft material incorporating the visceral arteries is technically feasible. The incidence of endoleaks is exceptionally low. It remains critical to follow the status of stented visceral vessels, and establish the long-term efficacy of this type of repair.

Aged↗