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At least 685 records · Page 38Linked to original sources

Virtual arterial endoscopy as a diagnostic aid in a patient with basilar artery fenestration and thromboembolic pontine infarct.

Focal signal intensity loss of the basilar artery on MR angiograms obtained in a 69-year-old man was considered to be caused by an embolus, and thrombolytic therapy was initiated. On the follow-up MR angiograms, the same oval signal intensity loss of the basilar artery was observed. On the basis of a virtual endoscopic look into the basilar artery, the diagnosis of a rare vascular anomaly--a fenestration of the basilar artery--was confirmed and the presence of a thrombus at the site of the signal intensity loss was excluded.

Aged↗

Noninvasive detection of a ruptured aneurysm at a basilar artery fenestration with submillimeter multisection CT angiography.

The criterion standard for the detection of intracranial aneurysms is digital subtraction angiography. MR imaging and CT provide good accuracy in the evaluation of brain arteries and aneurysms. We herein report a case of a ruptured aneurysm at a basilar artery fenestration. The diagnosis was assessed with 16-row multisection CT angiography and was confirmed by using digital subtraction angiography. The patient was successfully treated with coil placement.

Adult↗

Guided bone regeneration for fenestration defects in dental implants.

Guided bone regeneration has been applied in implant dentistry for increasing the width and height of the alveolar ridge in areas with insufficient bone. Various materials and techniques have been used for this purpose. It refers to a surgical procedure by which utilizing a mechanical barrier to create a secluded space around the defect to permit bone regeneration without the competition of other tissues. This report presents a case with buccal fenestrations on maxillary implant sites observed during a surgical procedure. An allograft and a non-resorbable membrane were concomitantly used to increase the width of the alveolar ridge. Hard tissue regeneration was evident clinically. The implants were restored for functioning and followed for 2 years. Factors affecting outcomes are also discussed. Membrane stability and the space-making effect remain the keys to success.

Bone Regeneration↗

Ovarian cyst fenestration via laparoscopy.

During laparoscopy for diagnosis or sterilization a small series of ovarian cysts was managed by aspiration only or by aspiration, biopsy and fenestration. If the enumerated criteria for cyst selection are followed, the technique described safely permits aspiration and provides data for a therapeutic plan. This method suggests a lower incidence of cyst recurrence.

Adult↗

DIASTOLIC OPENING OF THE AORTIC VALVE (AV) IN A CASE OF AORTIC INSUFFICIENCY DUE TO AV FENESTRATION.

A patient with severe aortic insufficiency due to fenestration of the non-coronary aortic valve leaflet is described. A preoperative echocardiogram demonstrated early closure of the mitral valve and early diastolic separation of the aortic valve leaflets. These findings disappeared after partial surgical correction and subsequent hemodynamic improvement. Premature opening of the aortic valve is common in severe aortic insufficiency.

Journal Article↗

Laparoscopic fenestration of symptomatic non-parasitic cysts of the liver.

BACKGROUND/AIMS: The use of laparoscopic technique for management of symptomatic liver cysts is documented to be a feasible and safe procedure with proved symptomatic relief. In the present study, we reviewed the results of this approach in the management of symptomatic liver cysts. METHODOLOGY: Retrospective review of all patients with symptomatic liver cysts that were treated by laparoscopic fenestration in our department over a 3-year period from 1999 to 2001. RESULTS: Ten patients were treated using a laparoscopic approach. All patients achieved short-term alleviation of symptoms and an uneventful postoperative course. The mean hospital stay was 3 days. Long-term follow-up (24 months) was available for all the patients. In all the patients, there was no clinical and radiographical recurrence. CONCLUSIONS: The present study confirms that relief of symptoms can be achieved with the laparoscopic approach for non-parasitic liver cysts. Omental packing is not necessary to prevent recurrence of simple hepatic cysts.

Aged↗

[Pericardioperitoneal fenestration for chronic exudative pericarditis using a subxiphoidal approach; report of a case].

A 77-year-old woman with a previous history of median sternotomy and collagen disease, presented with chief complaints of resting dyspnea as a result of recurrent pericardial effusions or restrictive ventilatory impairment. She experienced significant symptom amelioration after undergoing pericardioperitoneal fenestration. We weighed the positive against the negative of various pericardial effusion drainage methods in this study. This operative procedure is not innovative, but favorable because it can be carried out conveniently and safely, enabling early rehabilitation without appreciable postoperative complications.

Aged↗

Laparoscopic fenestration for a symptomatic simple cyst of the spleen.

Benign nonparasitic cysts of the spleen are a rare entity. Surgical treatment is indicated when they become symptomatic. Splenic conservative techniques are preferred, given the important immunologic role of the spleen. Laparoscopy has been used in the treatment of different splenic diseases with favorable results in terms of reduced postoperative discomfort, duration of hospital stay, and better cosmetic results. We report the case of a 35-year-old woman with a symptomatic simple cyst of the spleen that underwent a laparoscopic fenestration. The diagnostic and therapeutic implications are discussed focusing on the role of laparoscopy.

Adult↗

[Endonasal endoscopic chiasmapexy for secondary empty sella syndrome following fenestration of a Rathke's cleft cyst].

Drainage by fenestration of the cyst wall via the transsphenoidal apporach is the most commonly used treatment for symptomatic Rathke's cleft cyst (RCC). The same procedure is usually adopted for recurrence of RCC. We have encountered a case of secondary empty sella syndrome presented with visual field defects after repeated surgery for RCC. Secondary empty sella syndrome following the surgery of RCC is rare. The condition was explained by the mechanism that the optic nerve adhered to the cyst wall and it was tethered downward as the cyst shrank after the surgery. We treated the patient via the endonasal endoscopic transsphenoidal approach by placing holed silicone plates under the sellar floor to elevate the sellar contents and the optic nerve. Silicone plate is hard enough to support the sella and the small holes on it would facilitate drainage of the cyst contents. This method has proved useful as chiasmapexy for secondary empty sella syndrome after the surgery of RCC.

Adult↗

[Thoracoscopic pericardial fenestration--diagnostic and therapeutic aspects].

This article reports on four tumour patients with extensive, but cytologically innocuous pericardial effusion. In three cases, a tumour-cell-negative pleural effusion, on the left, was also present. Thoracoscopy showed that the pleura were unremarkable, whereupon, with the aid of the biopsy forceps--in one case the Nd:YAG laser--the pericardium was opened. The procedure provided diagnostically high-yielding material; in addition, pericardial tamponade was "permanently" eliminated (period of observation up to 4 years). This shows that, in addition to its diagnostic value, thoracoscopic pericardial fenestration also can be therapeutic. It represents an alternative to the surgical approach.

Humans↗

[Results of using decompression, denervation and fenestration (DDF) in the treatment of patients with coxarthrosis of different etiologies].

The authors present their results of treatment of coxarthrosis of various etiology (dysplastic, idiopathic, posttraumatic and aseptic necrosis of the femoral head) by means of an operation of denervation, decompression and fenestration on 35 hip joints in 31 patients with the follow-up period up to 6 years. The proposed operation is especially effective at the early stages of development of coxarthrosis; in the patients with aseptic necrosis of the femoral head the prognosticated remission may reach 10 years. Low traumatism and short duration of the operation with the preservation of the anatomic unity of the femur and the possibility of early activization allows to recommend this method for the treatment of idiopathic coxarthrosis in the elderly people with associated diseases when conservative treatment is hopeless and an extension of surgical intervention is impossible.

Adult↗

[A case of reexpansion pulmonary edema during fenestration of a giant hepatic cyst].

We experienced a case of reexpansion pulmonary edema during the fenestration of giant hepatic cyst. The patient was a 56 year-old female who had been suffering from dyspnea due to a large abdominal mass for 3 months. The preoperative chest X-ray revealed remarkable elevation of diaphragm (right third and left fifth intercostal spaces). The result of blood gas analysis showed hypoxemia and respiratory compensation for metabolic acidosis. By the drainage of 12L of the cyst fluid for 30 minutes during operation, bloody and foamy bronchial secretion spurted out. Vigorous respiratory management using PEEP was promptly started and continued postoperatively in ICU. The endotrachial tube was withdrawn on the 2nd postoperative day. The ratio of protein in airway secretion in to plasma protein was 0.78, and it appeared that the pulmonary edema was mainly caused by increased permeability of pulmonary capillary vessels.

Cysts↗

[A method for external and internal fenestration in the surgical treatment of idiopathic hydrocele].

A method is described for operative treatment of idiopathic hydrocele, which consists of tunnelling at 01 o'clock by the clock-dial to the right (11 o'clock to the left) with Payr's probe and from cupula to bottom of the space between the hydrocele sac and fascia spermatica interna and trans section of the thus created tunnel pass in the sac. Through the approach created in this way and at 180 degrees from the first incision (at 07 and respectively at 05 o'clock) from within outward a second incision of the sac is performed. The serous surface of the edges of the fenestrated openings is everted with three catgut sutures as a lapel. The method was applied on 7 patients 10 to 86 years of age. In the early postoperative period within an observation period from 3 to 19 months the characteristic and rather common complications in patients operated for hydrocele did not occur (hematocele, chylomas, which are mostly of ex vacuo type because of impaired blood supply and lymph system of the scrotum, abscesses, indurations of the scrotal and testicular tissues, relapses of the hydrocele, etc).

Adolescent↗

[Experimental and clinical analysis with the reconstruction of the fenestrated anterior wall of the sinus maxillaris].

A comparative macroscopie and hystomorphological analysis of shutting the fenestrated front wall of the maxillary sinus is done with 34 rabbits. An autogenic bony cover and grates made of chromium cobaltomolybdenum and non-coloured plastic. Are used 30 patients are operated on with the same materials with tracing the process of reparation and the aeration of the operated sinuses. The results are compared with another group of patients operated without a reconstruction of the facial bony defect. The importance of reconstruction for reparation of the ventilation ability of the operated sinuses in the after-operational period is proved.

Animals↗

Fenestrated subendothelial basement membranes in human retinal capillaries.

A correlated TEM and SEM study of human retinal capillaries and their associated basement membranes (BMs) was carried out. Control tissues show that these vessels are comprised of a continuous layer of endothelial cells separated from overlying intramural pericytes by a discontinuous subendothelial BM (EBM) which accommodates endothelial cell-pericyte (periendothelial) junctions. Three types of junctions exist, including: (1) "peg-and-socket" arrangements where cytoplasmic processes of the two cell layers interdigitate; (2) adhering plaques similar to desmosomes; and (3) cell/cell contacts where adjacent cell membranes appear to fuse or remain separated by a approximately 2 nm space. Following detergent solubilization, acellular retinal capillaries maintain their cylindrical histoarchitectures and all BM components are imaged by TEM and SEM. Topographical (SEM) studies of cryofractured samples show EBM surfaces with numerous (approximately 1.5/microns 2) oval fenestrations (100-450 nm diameter) that correlate well with EBM discontinuities occupied by periendothelial junctions in control tissues. It seems possible that these structures may play an important role in diabetic retinal neovascularization where pericytes are known to degenerate selectively. In this condition, preformed EBM deficiencies could facilitate endothelial cell migration and sprout formation, leading ultimately to the sequelae of proliferative diabetic retinopathy.

Basement Membrane↗

Charge effect on binding, uptake and transport of ferritin through fenestrated endothelium.

The binding, uptake and transport of hydrosoluble macromolecules as a function of their electric charge have been investigated in mouse pancreatic exocrine fenestrated endothelium. After intravenous injection of ferritin derivatives with different isoelectric points (3.7, 4.5, 7.0 and 8.4) specimens of pancreas were collected at 5, 25, 45 and 60 min and processed for electron microscopy. Although the concentrations (10 mg/ml) and injected volumes (1 ml/100 g body weight) were identical, the tracers with similar molecular weight (Mr approximately 960,000), but with different net electric charge, followed different routes in endocytotic and transcytotic processes. The endothelial cell internalizes ferritins into multivesicular bodies and lysosomes. While anionic ferritins are endocytosed via plasmalemmal vesicles (fluid phase endocytosis), the cationic derivatives are taken up exclusively by coated pits (adsorptive endocytosis). The anionic and neutral macromolecules seem to be transcytosed via plasmalemmal vesicles. The circulating polycations are aggregated by plasma proteins and transcytosed as such either in fluid phase by large vacuoles, or by adsorption on the coated structures. The first mechanism is physiological, the latter probably appears in unusual conditions by which the endothelium participates in the plasma clearance. Our findings indicate that, for the transport of macromolecules, the capillary endothelium can be accounted not only as a size barrier but also as a selective-differentiated charge barrier with complex and multiple mechanisms for the modulation of its transport systems. The endocytotic and transcytotic processes undergo the effect of net electric charge of the plasma components.

Animals↗