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At least 595 records · Page 33Linked to original sources
PubMed2003

Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy.

The main reason for conversion in laparoscopic donor nephrectomy (LDN) is peroperative bleeding. One of the advantages of hand-assisted laparoscopic donor nephrectomy (HDLN) is facilitated control in case of bleeding. This report describes two methods to avert conversion in HLDN in the case of abrupt major arterial bleeding. In the first case, during left HLDN the clips placed on the renal artery dislodged, and the surgeon managed to control the bleeding by compressing the focus of the bleeding with his finger. A balloon occlusion catheter was inserted through a groin incision in the aorta and advanced to the origo of the renal artery. Due to control of the hemorrhage, it was possible to close the renal artery stump by laparoscopic suturing, and a conversion was averted. The patient was discharged after 5 days, without signs of damage to the remaining kidney. In the second case, during right HLDN, the clips on the renal artery dislodged during stapling of the renal vein. The bleeding was controlled by finger compression and new clips were placed. The cuff of the artery was long enough to be clipped again. The patient was discharged after 5 days. Graft function was excellent in both cases. Major arterial bleeding can be controlled and managed in hand-assisted laparoscopic surgery. The use of a balloon occlusion catheter is an elegant way to avert conversion.

Adult↗
PubMed2003

Choledocholithiasis caused by migration of a surgical clip into the biliary tract following laparoscopic cholecystectomy.

As experience with laparoscopic cholecystectomy (LC) has increased, so have the number and variety of complications. We report a case of choledocholithiasis caused by migration of a surgical clip applied during LC. A 57-year-old Japanese man who had undergone LC 6 years previously was referred to our hospital with pruritus and jaundice. Magnetic resonance cholangiopancreatography and ultrasonography revealed a solid mass in the common hepatic duct and dilatation of the intrahepatic bile ducts. Abdominal arteriography demonstrated interruption of the right hepatic artery by surgical clips. Five days after a biopsy of the mass was performed through a percutaneous transhepatic biliary drainage tube, the mass moved to the terminus of the common bile duct along with one of the surgical clips. A basket catheter was used to remove the mass via endoscopy. Despite the fact that other clips in the common hepatic duct were partially exposed, the patient has been well for 2 years with no additional interventions.

Bile Ducts, Intrahepatic↗
PubMed2002

Failure of endoscopic removal of common bile duct stones due to endo-clip migration following laparoscopic cholecystectomy.

We report herein an extremely rare complication; namely, endo-clip migration into the common bile duct, following laparoscopic cholecystectomy, that occurred in a 57-year-old man. He underwent laparoscopic cholecystectomy, but postoperative bile leakage occurred from the cystic duct stump and he was treated by conservative drainage for 1 month. Five years later, he complained of vomiting and pain in the right hypochondrium, and he was admitted for investigations of jaundice and liver dysfunction. Computerized tomography scanning of the abdomen and endoscopic retrograde cholangiography revealed that several calculi, with six endo-clips as nuclei, had migrated into the biliary tract. Endoscopic removal of the calculi following endoscopic sphincterotomy, using a basket catheter, was unsuccessful, and it was therefore necessary to remove the basket catheter surgically. The mechanism of endo-clip migration and the method for removing the endo-clips are briefly discussed.

Biliary Tract Surgical Procedures↗
PubMed2006

Comparison between clipping and coiling on the incidence of cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

Cerebral vasospasm is one of the most important complications of aneurysmal subarachnoid hemorrhage. The effect of aneurysm occlusion technique on incidence of vasospasm is not exactly known. The objective was to analyze surgical clipping versus endovascular coiling on the incidence of cerebral vasospasm and its consequences. Using the MEDLINE PubMed (1966-present) database, all English-language manuscripts comparing patients treated by surgical clipping with patients treated by endovascular coiling, regarding vasospasm incidence after aneurysmal subarachnoid hemorrhage, were analyzed. Data extracted from eligible studies included the following outcome measures: incidence of total vasospasm, symptomatic vasospasm, ischemic infarct vasospasm-induced and delayed ischemic neurological deficit (DIND). A pooled estimate of the effect size was computed and the test of heterogeneity between studies was carried out using The Cochrane Collaboration's Review Manager software, RevMan 4.2. Nine manuscripts that fulfilled the eligibility criteria were included and analyzed. The studies differed substantially with respect to design and methodological quality. The overall results showed no significant difference between clipping and coiling regarding to outcome measures. According to the available data, there is no significant difference between the types of technique used for aneurysm occlusion (clipping or coiling) on the risk of cerebral vasospasm development and its consequences.

Cerebral Infarction↗
PubMed1982

Angiotensin II is a necessary component for the development of hypertension in the two kidney, one clip rat.

The current study was undertaken to define the role of the renin-angiotensin system in the development of hypertension in the two kidney, one clip Goldblatt rat. Captopril was administered orally (100 mg/kg/day) to two groups of rats (n = 8 each) 24 hours before and each day after unilateral renal artery clipping (0.2 mm internal diameter): the drug was given for either 16 weeks (group I) or 24 weeks (group II). Sham-operated (n = 5) and Goldblatt (n = 8) rats not receiving captopril were prepared for comparisons of plasma renin activity and systolic blood pressure. Indomethacin (20 mg/kg/day subcutaneously) was administered for 48 hours concomitantly with captopril to the rats in group I. In group II, systolic blood pressure was monitored for 7 weeks after cessation of captopril. Continual captopril administration to Goldblatt rats completely prevented the rise in systolic blood pressure, a rise that was observed in Goldblatt rats not receiving captopril. Whereas systolic blood pressure of captopril-treated rats approximated 100 mm Hg throughout the study, that of Goldblatt rats not receiving the drug increased to nearly 180 mm Hg within 6 weeks after clipping. Systolic blood pressure of sham-operated rats remained normal. Indomethacin did not change systolic blood pressure in the drug-treated rats in group I. On cessation of captopril therapy in group II, systolic blood pressure increased gradually in a manner that paralleled the development of the disease in the Goldblatt rats that did not receive captopril. Plasma renin activity was determined in Goldblatt and sham-operated rats at either 16 weeks (group I) or 24 weeks (group II) after clipping; the rats from either group with mild hypertension (systolic blood pressure less than 180 mm Hg) had normal plasma renin activity whereas those with severe hypertension (systolic blood pressure greater than 180 mm Hg) had greatly elevated plasma renin activity. In summary, captopril can completely prevent the increase in systolic blood pressure for up to 24 weeks in Goldblatt rats, and this hypotensive effect is not mediated by the prostaglandins. It is concluded that the renin-angiotensin system is a necessary component of the hypertensive process in this experimental model.

Angiotensin II↗
PubMed1977

Long-term follow-up of vena caval clips and umbrellas.

Fifty-one consecutive cases of inferior vena caval interruption for documented pulmonary embolism are reported. Forty-four patients underwent transabdominal vena caval clipping using the multichannel Adams-DeWeese clip, and seven critically ill patients were treated with vena caval umbrella. Operative mortality was 4 per cent. Only one patient developed edema attributable to clipping whereas postinterruption stasis sequelae were common after umbrella insertion. Vena cavography at six months and eight years demonstrated 85 per cent patency in the clip group and 16 per cent in the umbrella group.

Follow-Up Studies↗
PubMed1990

Pharmacologic response of endothelium to microvascular temporary clip application.

To assess the effects of microvascular temporary clip application on vessel relaxing capability and endothelial substance release, the carotid rings of rats clipped for various durations were studied via bioassay. Noradrenaline and phenylephrine produced an immediate contraction and subsequent relaxation that failed to be suppressed by lysine acetylsalicylate or nicotine in the controls and in the arteries clipped for 0.5, 1, and 5 minutes; however, this relaxation was greatly reduced when the duration was 10 minutes. The results suggest the possible role of inadequate endothelium-derived relaxing factor release following prolonged application of the clips.

Animals↗
PubMed1995

HLA-DM induces CLIP dissociation from MHC class II alpha beta dimers and facilitates peptide loading.

Human leukocyte antigen DM (HLA-DM) molecules are structurally related to classical MHC class II molecules and reside in the lysosome-like compartment where class II-restricted antigen processing is thought to occur. Mutant cell lines lacking HLA-DM are defective in antigen processing and accumulate class II molecules associated with a nested set of invariant chain-derived peptides (class II-associated invariant chain peptides, CLIP). Here we show that HLA-DM catalyzes the dissociation of CLIP from MHC class II-CLIP complexes in vitro and facilitates the binding of antigenic peptides. The reaction has an acidic pH optimum, consistent with its occurrence in a lysosome-like compartment in vivo. Antibody blocking experiments suggest that a transient interaction between HLA-DM and the MHC class II-CLIP complex is required.

Amino Acid Sequence↗
PubMedDate not supplied

Neuronal transmission of hippocampal CA1 neurones is modulated by corticotropin-like intermediate lobe peptide [CLIP; ACTH(18-39)].

The study was conducted to test whether CLIP [ACTH(18-39)] influences the neuronal transmission and the induction of long-term potentiation (LTP) in the hippocampus. The population spike was recorded in the hippocampal CA1 region of freely moving rats before and after intracerebroventricular (ICV) administration of CLIP in comparison to ACTH and saline (controls). After infusion of CLIP, the population spike amplitude (PSA) rose to about 200% of baseline values. After reaching this level, it was impossible to induce a further increase of PSA by tetanization. However, if the stimulus intensity was reduced to a new baseline level, electrically induced LTP could be observed. There were no significant changes after infusion of ACTH. Our results indicate that the ICV administration of CLIP leads to an enhancement of excitability in the hippocampal CA1 region, which might be independent of LTP.

Adrenocorticotropic Hormone↗
PubMed1984

Urinary 6-keto PGF1 alpha and PGE2 in two kidney-one clip hypertension in the rat.

The 24 hour urinary excretion of 6-keto PGF1 alpha and PGE2 was compared in 2 kidney-1 clip rats developing hypertension within 12 weeks of renal artery clipping with rats remaining normotensive over this period. Although systolic blood pressure was markedly elevated in the hypertensive (210 +/- 5.1 mm Hg), in contrast with the normotensive (141 +/- 1.9 mm Hg) group, urinary levels of 6-keto PGF1 alpha (26.1 +/- 3.4 and 22.1 +/- 2.7 ng/24 h, respectively) and PGE2 (52.8 +/- 28 and 53.3 +/- 10.8 ng/24 h) were not significantly different. Treating the 2 kidney-1 clip normotensive group with indomethacin (3.0 mg/kg, by intraperitoneal injection) twice-weekly for 3 weeks reduced 6-keto PGF1 alpha excretion from 22.1 +/- 2.7 to 8.4 +/- 2.2 ng/24 h (P less than 0.002) and PGE2 from 53.3 +/- 10.8 to 8.7 +/- 1.8 ng/24 h (P less than 0.002) but did not change blood pressure when compared with a similar group given buffer vehicle only. These findings do not support a role for renal prostaglandins in 2 kidney-1 clip hypertension in the rat.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Different excretion pattern of urinary PGE2 and 6-keto-PGF1 alpha in two kidney-one clip Goldblatt rats.

Changes in blood pressure and 24 hour urinary excretion of PGE2 and 6-keto-PGF1 alpha have been studied during ten weeks after renal artery clipping or sham operation in rats. From the second week on, systolic blood pressure was significantly increased in the two kidney-one clip rats as compared to controls. Maximal differences were reached in the 10th week after the operation (145 +/- 8 vs 116 +/- 3.2 mm Hg; p less than 0.001). Urinary PGE2 levels showed markedly elevated values versus controls from the 6th week on (p less than 0.001). However, no significant changes in urinary 6-keto-PGF1 alpha excretion were observed between the groups during the whole experimental period. These findings suggest that renal PGE2 may be involved in the pathophysiology of blood pressure control in the two kidney-one clip model, whereas, 6-keto-PGF1 alpha seems not to be altered after renal artery clipping.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Distribution and colocalization of delta sleep inducing peptide (DSIP) with corticotropin-like intermediate lobe peptide (CLIP) in the human hypophysis.

DSIP and CLIP [ACTH(18-39)] immunoreactive (IR) neurons and fibers were examined in the human hypophysis and pituitary stalk using immunmohistofluorescence and peroxidase-antiperoxidase methods. Double-stained and adjacent stained sections demonstrate that DSIP is colocalized in about 75% of CLIP-IR-like cells in the anterior pituitary and in residual intermediate lobe cells. Only few CLIP-IR-like fibers are observed in the posterior lobe. On the contrary, a high density of DSIP-IR fibers is visualized in the stalk. It is suggested that DSIP acts as a sleep promoting factor (one of many other actions) and that CLIP increases the paradoxical sleep, so that these two peptides could play a role in the regulating system of the sleep-waking cycle.

Adrenocorticotropic Hormone↗
PubMed1993

Breast conserving surgery and irradiation: the importance of demarcating the excision cavity with surgical clips.

PURPOSE: To determine whether or not the surgical scar and surgical induration are suitable landmarks for localizing the boost field in the treatment of patients undergoing breast conservation surgery and irradiation. METHODS AND MATERIALS: Thirty-five patients had surgical clips placed in the excision cavity at the time of tumor excision. The boost field locations for these patients were determined by encompassing the surgical induration with a minimum 2 cm margin or, when there was no induration, by encompassing the incision scar with a 3 cm margin. Simulator radiographs were taken with the boost field margins marked with solder wire. RESULTS: The simulator radiographs showed that the excision cavity clips were at or outside the boost field margins in 19 patients, 54% of the entire group. An unexpected finding was that, in six of the 23 patients with the surgical scar 2 cm medial or lateral to the areola, the excision cavity clips were inadequately covered by tangential fields even though the fields appeared to be adequate based on external landmarks. CONCLUSION: (a) This study suggests that the skin incision and surgical induration are not reliable landmarks for boost field localization. (b) Without surgical clips, part of the excision cavity would have underdosed by the tangential fields in 23% of patients with medial or lateral surgical scars.

Breast Neoplasms↗
PubMed2006

The effects of smoking and abstinence on experience of happiness and sadness in response to positively valenced, negatively valenced, and neutral film clips.

Incentive motivation theories of addiction suggest that behavioural concomitants of compromised mesocorticolimbic reward activity during abstinence might include decreased affective reactions to natural reinforcers. This study tested implications for hedonic reactions in abstinent smokers. It was hypothesised that positively valenced (pleasurable) film clips would elicit lower ratings of happiness in abstinent than satiated smokers. Twenty-nine smokers, randomly assigned to either an 'abstinent' or a 'satiated' condition, and 15 non-smokers took part in a single session in which they rated (i) signs and symptoms of nicotine withdrawal and (ii) affective responses to positively valenced, negatively valenced, and neutral film clips. Compared with satiated smokers, abstinent smokers rated positive clips as eliciting significantly lower levels of happiness, and this was independent of self-reported nicotine withdrawal symptoms; the scores of non-smokers fell between those of abstinent and satiated smokers, more closely approximating those of the latter. By contrast, sadness ratings in response to negative clips were not affected by smoking status, indicating that the effect on happiness was not simply due to general emotional blunting. These results suggest that, for regular smokers, stimuli that are motivationally salient for the general population may elicit reduced positive affective responses during periods of abstinence.

Adolescent↗
PubMed2005

Surgical revision after percutaneous mitral valve repair with a clip: initial multicenter experience.

PURPOSE: Almost 50,000 mitral valve operations are performed annually in the United States, with an increasing number of repairs. Recently, a percutaneous mitral valve repair option that achieves edge-to-edge approximation with a clip has been described in patients with mitral regurgitation. DESCRIPTION: We describe 6 patients from three centers with mitral regurgitation after percutaneous repair who underwent reintervention. During open surgical revision, the clips were uneventfully removed in all patients with no limitation in surgical options. Five patients underwent repair and 1 underwent replacement. EVALUATION: After surgical revision, mitral regurgitation was significantly decreased, and all but 1 patient underwent uneventful recovery. One patient developed ilio-femoral deep venous thrombosis that was treated successfully with anticoagulation. CONCLUSIONS: Preserving standard of care options is critical with any evolving technology in the event of initial treatment failure. Standard surgical options were preserved in all of the patients who underwent percutaneous mitral valve edge-to-edge repair. Furthermore, a thorough understanding of the clip design, in particular its unlocking mechanism, is essential and facilitates surgical clip removal.

Adult↗
PubMed2004

Prospective randomized, controlled study of postoperative pain after titanium silicone rubber clip or Silastic ring tubal occlusion.

OBJECTIVE: To determine if laparoscopic sterilization using the Filshie clip causes less postoperative pain as compared to the Falope ring during the first 24 h after surgery. STUDY DESIGN: Forty subjects were enrolled. Five milliliters of 0.5% bupivicaine was injected at each of the two incision sites and 5 mL was dripped onto each fallopian tube. Subjects then received one Filshie clip and Falope ring on opposite fallopian tubes; the side of occlusion was randomized. Subjects were questioned about pain prior to the first administration of analgesics postoperatively, 1 and 2 h after surgery, at discharge, and 24 h after surgery. RESULTS: Forty subjects completed the study; 32 without major deviations from protocol. There was no significant difference in pain between sides with the Filshie clip or Falope ring at any times evaluated. CONCLUSION: There was no significant reduction in the postoperative pain associated with the Filshie clip as compared to the Falope ring within 24 h after surgery.

Adult↗
PubMed2004

CLIP-170/tubulin-curved oligomers coassemble at microtubule ends and promote rescues.

BACKGROUND: CLIP-170 is a microtubule binding protein specifically located at microtubule plus ends, where it modulates their dynamic properties and their interactions with intracellular organelles. The mechanism by which CLIP-170 is targeted to microtubule ends remains unclear today, as well as its precise effect on microtubule dynamics. RESULTS: We used the N-terminal part of CLIP-170 (named H2), which contains the microtubule binding domains, to investigate how it modulates in vitro microtubule dynamics and structure. We found that H2 primarily promoted rescues (transitions from shrinkage to growth) of microtubules nucleated from pure tubulin and isolated centrosomes, and stimulated microtubule nucleation. Electron cryomicroscopy revealed that H2 induced the formation of tubulin rings in solution and curved oligomers at the extremities of microtubules in assembly conditions. CONCLUSIONS: These results suggest that CLIP-170 targets specifically at microtubule plus ends by copolymerizing with tubulin and modulates microtubule nucleation, polymerization, and rescues by the same basic mechanism with tubulin oligomers as intermediates.

Cryoelectron Microscopy↗
PubMed2006

Cloning and characterization of a shrimp clip domain serine protease homolog (c-SPH) as a cell adhesion molecule.

Clip domain serine protease homologs (c-SPHs) are involved in various innate immune functions in arthropods such as antimicrobial activity, cell adhesion, pattern recognition, opsonization, and regulation of the prophenoloxidase system. In the present study, we cloned a c-SPH cDNA from tiger shrimp (Penaeus monodon) hemocytes. It is 1337 bp in length with a coding region of 1068 bp consisting a protein of 355 amino acid residues. The deduced protein includes one clip domain and one catalytically inactive serine protease-like (SP-like) domain. Its molecular weight is estimated to be 38 kDa with an isoelectric point of 7.9. The predicted cutting site of the signal peptide is located between Gly(21) and Gln(22). We aligned 15 single clip domain SPH protein sequences from 12 arthropod species; the identity of these clip domains is low and that of SP-like domains is from 34% to 46%. The conserved regions are located near the amino acid residues which served as substrate interaction sites in catalytically active serine protease. Phylogenetically, the tiger shrimp c-SPH is most similar to a low molecular mass masquerade-like protein of crayfish, but less similar to c-SPHs in Chelicerata and Insecta. Nested reverse transcription polymerase chain reaction (RT-PCR) revealed that c-SPH mRNA is expressed most in tissues with the highest hemocyte abundance. Antimicrobial and opsonization activities of the molecule were not detected. The expression of c-SPH mRNA in hemocytes was up-regulated at the 12-day post beta-glucan immersion. Recombinant c-SPH could significantly enhance hemocyte adhesion. The result suggests that the shrimp c-SPH protein plays a role in innate immunity.

Amino Acid Sequence↗