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At least 739 records · Page 41Linked to original sources
PubMed1984

High failure rate of a plastic tubal (Bleier) clip.

Sixteen intrauterine pregnancies (8.6%) have been documented among 187 women who had undergone direct placement of American-made Bleier clips for sterilization. Of these, five pregnancies (10.2%) followed clip placement in 49 cesarean deliveries, nine pregnancies (8.2%) followed 110 infraumbilical postpartum procedures, and two pregnancies (7.1%) occurred in 28 interval minilaparotomy patients. Resterilization by tubal segment excision has been performed in five unsuccessful cases. In one case, the excised portions of tube with clips in place were studied by radiologic and histologic methods. Tubal patency may persist if the oviduct is trapped in the catch portion of the clip.

Adult↗
PubMedDate not supplied

The intelligibility of whitened and peak clipped speech.

Consonant-nucleus-consonant monosyllabic words were filltered such that each spectral component had equal energy (i.e., "whitened") and peak clipped in one of four ways: minimal, 20, 30, and 40 dB of clipping. In addition, unmodified consonant-nucleus-consonant words were used as stimuli. These different types of sppech were presented to 20 persons with normal hearing at various sensation levels. The results indicate that whitening and peak clipping do not substantially degrade speech intelligibility. In fact, under some conditions whitening and peak clipping may slightly enhance intelligibility.

Adult↗
PubMed1982

Preoperative hair removal: a random prospective study of shaving versus clipping.

We report the results of a random, prospective study of electrical clipping versus routine razor shaving in the removal of hair immediately before operation. Two hundred patients having elective inguinal herniorrhaphy according to strict protocol were included in this study. Unsatisfactory skin preparation, as evidenced by gross cuts made in the skin during hair removal, was noted in 7% of those shaved and 4% of those clipped. Two subcutaneous wound infections occurred in the shaved group (2%) and one in the clipped group (1%). This study indicates that preoperative clipping of hair with electric barber's clippers immediately before operation is a safe, well tolerated procedure that does not increase the risk of postoperative wound infection.

Adult↗
PubMed1982

[Recurrent cerebral aneurysm after successful clipping of aneurysmal neck].

Neck clipping has been widely believed to be one of the most reliable and typical treatment of the cerebral aneurysm. Recently we experienced two cases of recurrence of cerebral aneurysm several years after surgery, in spite of confirmation of perfect neck clipping not only by intraoperative inspection but postoperative angiographical studies. The histological findings demonstrated that the arterial wall at the clip edge changed into thinning, interruption, and atrophy both of the muscle layer and internal elastic lamina. Therefore, local fragility of the arterial wall adjacent to clip edge seemed to cause formation of a new aneurysm. In addition, we discussed the usefulness of riskless CT in postoperative follow-up study of the cerebral aneurysm.

Carotid Arteries↗
PubMed1981

[Superior Foville syndrome after clipping of basilar bifurcation aneurysm--case report (author's transl)].

The patient was a 48-year-old housewife, who had a sudden onset of severe headache followed by loss of consciousness for a few hours on the day of admission. Initially she showed slight restlessness due to headache, neck stiffness and subhyaloid hemorrhage. Four-vessel study revealed a basilar aneurysm on right retrograde brachial angiography and anterior communicating aneurysm on left carotid angiography. Two weeks after the onset, when she had no neurological deficit except for intermittent appearance of disorientation, both aneurysms were successfully clipped through right pterional approach of Yasargil. The subarachnoid hemorrhage was apparently due to basilar bifurcation aneurysm. Postoperatively, she showed right hemiparesis including her face, aniscocoria (left, 4 mm, oval: right, 1.5 mm, round) and conjugate deviation toward the left. The disturbance of conjugate eye movement and the hemiparesis completely disappeared in 2 and 7 days respectively. The patient was discharged 4 weeks postoperatively with mild left 3rd nerve palsy. At present, one year postoperatively, she is fully engaged in her housewife life without any neurological deficits. A case of superior Foville syndrome combined with Weber syndrome after clipping of basilar bifurcation aneurysm was reported and its anatomicoclinical mechanism was reviewed. The pathogenesis was supposed to be left midbrain ischemic lesion due to circulatory disturbance of P-1 perforators (P-1: proximal posterior cerebral artery); e.g., occlusion on clipping of vasospasm. This P-1 perforator syndrome after aneurysmal clipping has been reported only little. The importance of preservation of these perforators with careful dissection and manipulation under microscopy was emphasized.

Basilar Artery↗
PubMedDate not supplied

Long term follow-up of prophylactic caval clipping.

120 high risk patients who underwent prophylactic inferior vena cava clipping were retrospectively evaluated to determine the incidence of post clipping leg swelling and pulmonary embolism. Each one of those patients had at least two criteria for the clipping. These criteria of high risk factors were precisely identified. There were two patients who had postoperative pulmonary embolism but none of them was fatal, i.e. less than two per cent. Two patients developed severe leg swelling (less than two per cent) and six had mild leg swelling (less than six per cent). Prophylactic inferior vena cava clipping is a safe and effective mean to prevent post-operative pulmonary embolism.

Adult↗
PubMed1994

Heart prolyl endopeptidase activity in one-kidney, one clip hypertensive rats.

1. Heart mass, prolyl endopeptidase activity and fractionated proteins from heart tissue were studied in one-kidney, one clip hypertensive rats (N = 6) and compared to sham-operated rats (N = 6). 2. Body weight, arterial pressure and tissue mass were measured 4 weeks after artery clipping. Z-Gly-Pro-p-nitroaniline hydrolysis was used to measure tissue prolyl endopeptidase activity in the homogenate. Protein was fractionated into the soluble and myofibrillar fractions. 3. In the normotensive rats, prolyl endopeptidase activity expressed in terms of protein specific activity (microM substrate hydrolyzed h-1 mg supernatant protein-1) occurred in atria and was 2.5-fold higher than in the ventricles (3.79 +/- 0.20 vs 1.44 +/- 0.02, P < 0.05). In the one-kidney, one clip hypertensive rats, the left ventricle tissue increased 1.7-fold (2.27 +/- 0.11 vs 3.72 +/- 0.11 mg wet weight tissue/g body weight, P < 0.001), the soluble protein fraction (54.86 +/- 3.60 vs 57.38 +/- 6.64 mg/g wet weight tissue) was unchanged, while the myofibrillar fraction increased 1.9-fold (118.9 +/- 9.09 vs 229.8 +/- 8.47 mg/g wet weight tissue, P < 0.001). 4. The specific activity of the atrial and ventricular prolyl endopeptidase decreased in atria and increased in ventricles as the result of hypertension (3.79 +/- 0.2 vs 2.84 +/- 0.13 and 1.44 +/- 0.02 vs 1.87 +/- 0.13; respectively). These regional differences in prolyl endopeptidase enzyme content caused by one-kidney, one clip hypertension in neurosecretory and non-neurosecretory heart areas suggest that this enzyme plays a local role in the turnover of specific polypeptides.

Analysis of Variance↗
PubMed1996

CT angiography in the examination of patients with aneurysm clips.

The use of CT angiography is described in three patients for the evaluation of intracranial clips after surgery for an aneurysm. A postprocessing technique is described in which shaded-surface-display models were superimposed on maximum intensity projection CT angiograms. CT angiograms showed residual aneurysmal filling adjacent to a clip, patency of a vessel thought to be compromised by recent clip placement, and errant position of a clip, which required repeat surgery.

Cerebral Angiography↗
PubMed1996

[Recurrence of a giant fusiform aneurysm after neck clipping: case report].

The patient was a 71-year-old female. On December 20, 1995, she suddenly developed a severe headache with vomiting and was transferred to our hospital. On admission, her conciousness level was 1-2 on the Japan Coma Scale, but there was no neurological deficit except for right oculomotor palsy. Computed tomography showed subarachnoid hemorrhage which had permeated the right lateral ventricle. On cerebral angiography, a giant fusiform aneurysm in the right internal carotid artery was recognized. During the emergency operation, neither neck clipping nor carotid reconstruction was possible because of the tight adhesion of the aneurysm to the peripheral tissue. On account of this, proximal clipping of the carotid artery with external carotid-middle cerebral artery anastomosis with saphenous vein graft was selected. This patient had had an episode of subarachnoid hemorrhage owing to rupture of the right internal carotid-posterior communicating artery aneurysm ten years earlier. At that time, the aneurysmal neck was clipped with a slight residual neck and she left the hospital on foot. Five days later, when the aneurysm was found to be completely thrombosed on CT scan, antiplatelet therapy was started. Although low density areas which corresponded to the regions fed by the right anterior choroidal artery were presented, re-rupture did not occur. Follow-up angiography showed that the aneurysm was completely thrombosed and that the right middle cerebral and the anterior cerebral artery blood was circulated via the vein graft. Among recurrent cases of aneurysm after neck clipping, it is unusual for a giant fusiform aneurysm to be recognized. The growth may have been caused by sclerotic change of the arterial wall. Oculomotor palsy may have delayed the detection of the recurrence of the aneurysm. When residual neck is presented on follow-up angiography, the next angiography should be carried out within at least three years. In this case, antiplatelet therapy was effective to prevent thromboembolism from the aneurysm.

Aged↗
PubMed1996

[Anesthesia combined with profound hypothermia using cardiopulmonary bypass for clipping of giant basilar artery aneurysm].

A 52 year-old female was scheduled for clipping of giant basilar artery aneurysm. This operation needed temporary clipping of the basilar artery for 30-40 minutes, and preoperative examination suggested that some regions would become ischemic by temporary clipping. Therefore profound hypothermia using cardiopulmonary bypass (CPB) and thiamylal loading were planned to prevent cerebral damage during the operation. Anesthesia was induced with thiamylal, fentanyl, and isoflurane in nitrous oxide and oxygen. Following administration of vecuronium, trachea was intubated. Two hours after the start of surgery, thiamylal was titrated to obtain EEG patterns of burst-suppression before CPB and the infusion was continued until CPB was discontinued. With burst-suppression present, CPB was instituted. Hypothermia below 20 degrees C at pulmonary artery temperature was maintained until the aneurysm was clipped and bleeding from the operating site was controlled. Cooling and rewarming by CPB were carried out with ease and uneventfully. The patient had no neurological complications postoperatively.

Basilar Artery↗
PubMed1997

Identification of residues in the class II-associated Ii peptide (CLIP) region of invariant chain that affect efficiency of MHC class II-mediated antigen presentation in an allele-dependent manner.

Invariant chain (Ii) associates with class II MHC molecules and is crucial for Ag presentation by class II molecules. A general explanation for how invariant chain (Ii) associates with polymorphic MHC class II molecules has been suggested by the crystallographic structure of CLIP (class II-associated Ii peptide) complexed with an HLA class II molecule, HLA-DR3. We show here that methionine residues at positions 93 and 99 in Ii are important in MHC class II-mediated Ag presentation, but function in an allele-dependent manner. Introduction of a Met-->Ala mutation at position 99 in Ii (M99AIi) impaired presentation of peptides derived from exogenous proteins by I-Ad and I-Au class II molecules. Mutating Met-->Ala in Ii at position 93 (M93AIi) abrogated presentation by I-Au molecules, but not by I-Ad. Impaired Ag presentation was associated with conformationally altered expression of I-A molecules on the surface of cells expressing mutated Ii. Cell surface CLIP staining and immunoprecipitation studies showed that both I-Ad and I-Au molecules were associated with an increased abundance of Ii peptides, CLIP, in cells expressing mutated Ii. These results show that methionine 93 and methionine 99 play an important physiologic role in Ii association with class II molecules by regulating release of CLIP from class II in the endocytic compartments to allow binding of cognate peptides.

Alanine↗
PubMed1990

Long-term follow-up of laparoscopic sterilizations by electrocoagulation, the Hulka clip and the tubal ring.

A follow-up study of 499 women who underwent sterilization between August 1973 and May 1976 at the Siriraj Hospital in Bangkok, Thailand, and had long-term (4-12 years post-surgery) follow-up is described. Women were sterilized through participation in one of three studies conducted at this hospital. In the first study, 124 underwent sterilization using the Hulka clip via laparoscopy; 67.7% of these women returned for a long-term follow-up visit. In the second study, 300 women were randomly allocated to the Hulka clip or to unipolar electrocoagulation (cautery) via laparoscopy; 70.7% of the women from this study returned for a long-term follow-up visit. The final study was a randomized trial comparing the tubal ring and unipolar electrocoagulation occlusion techniques in 300 cases. Long-term follow-up visits were recorded for 207 women (69.0%) from this study. Five technical failures (procedures not performed or completed as planned) and six non-interval cases were excluded from follow-up analyses. A total of 713 interval patients were eligible for follow-up. Long-term follow-up was initiated in 1978 and continued through 1986. Late sequelae of sterilization, including pregnancies and pelvic surgery, are discussed with regard to type and time of tubal occlusion. One intrauterine and two ectopic pregnancies were reported among women who were sterilized with cautery; one ectopic pregnancy was reported by a woman sterilized with the Hulka clip. Pelvic or abdominal surgeries were reported in 27 cases. Most (greater than 98%) women indicated that they were satisfied with their sterilization procedure.

Adult↗
PubMed1975

Sterilization by spring clip: a report of 1000 cases with a 6-month follow-up.

In September 1972, clinical trials of a spring-loaded clip for laparoscopic sterilization were begun and extended to a number of centers in the United States and overseas. As of March 1974, more than 1000 patients had undergone the procedure, usually performed under local anesthesia in an outpatient setting, with no fixed contraindications. Complications and pregnancy rates based on a preliminary 6-month follow-up are presented. Complications due to application of the clip appeared to be limited to postoperative cramps lasting 24 to 48 hours (26% of the patients). No ectopic pregnancies were reported. Pregnancies, when corrected for unsuspected pregnancies and misapplication of the clip, occurred in 2 of these first 1000 patients. The difficulties and relative contraindications learned from this unselected series and the advantages over electrocagulation techniques are discussed.

Abortion, Spontaneous↗
PubMed2000

CLIP-derived self peptides bound to MHC class II molecules of medullary thymic epithelial cells differ from those of cortical thymic epithelial cells in their diversity, length, and C-terminal processing.

Medullary thymic epithelial cells (mTEC) are able to present soluble antigens to CD4+ helper T cell lines, whereas cortical thymic epithelial cells (cTEC) are not (Mizuochi, T., et al., J. Exp. Med. 1992. 175: 1601-1605). In addition, class II heterodimers from mTEC migrated with apparently less relative molecular mass in SDS-PAGE than those from cTEC (Kasai, M., et al., Eur. J. Immunol. 1998. 28:1867-1876). To investigate the cause of the distinct migration profiles of class II heterodimers in both TEC types, class II heterodimer-associated peptides were analyzed by matrix-assisted laser desorption ionization mass spectrometry. Self peptides from cTEC were shown to vary moderately in length and to be highly diverse, including low amounts of CLIP (class II-associated invariant chain peptide) variants. On the other hand, self peptides from two mTEC consisted predominantly of two CLIP variants with exceptional C-terminal extensions. C-terminally overhanging residues of CLIP in mTEC may be responsible for the distinct migration of class II heterodimers in SDS-PAGE. Differences in migration of class II heterodimers on SDS gels was also observed in H2-DM+ vesicles isolated from both TEC. The possible contribution of self peptides bound to class II heterodimers in TEC to positive or negative selection of T cells in the thymus is discussed.

Amino Acid Sequence↗
PubMed2000

Safety of MR scanning in patients with nonferromagnetic aneurysm clips.

The purpose of this study was to report our surveillance of patients with nonferromagnetic aneurysm clips (NFAC) who have undergone magnetic resonance imaging (MRI). Forty-six patients with NFAC underwent MRI over a 7-year period. Medical records were studied for evidence of subjective or objective clinical findings as a result of the MRI scan. In two patients with subjective complaints, computed tomograms (CT) were reviewed and patient interviews conducted. No significant neurologic signs or longterm symptoms were experienced. Two patients did not complete their MRI scans due to transient unilateral head pain in one and head "pressure" in another. CT scans in these patients demonstrated no evidence for hemorrhage or visible change in clip position. We documented no objective adverse outcome of patients undergoing MRI with NFAC, confirming that MRI can be performed safely in patients with nonferromagnetic aneurysm clips. The cause of subjective complaints in two of our patients is unknown.

Adult↗
PubMed2004

LIMK1 and CLIP-115: linking cytoskeletal defects to Williams syndrome.

Williams Syndrome is a developmental disorder that is characterized by cardiovascular problems, particular facial features and several typical behavioral and neurological abnormalities. In Williams Syndrome patients, a heterozygous deletion is present of a region on chromosome 7q11.23 (the Williams Syndrome critical region), which spans approximately 20 genes. Two of these genes encode proteins that regulate dynamic aspects of the cytoskeleton of the cell, either via the actin filament system (LIM kinase 1, or LIMK1), or through the microtubule network (cytoplasmic linker protein of 115 kDa, or CLIP-115). The recent findings that knockout mice lacking LIMK1 or CLIP-115 have distinct neurological and behavioural phenotypes, indicates that cytoskeletal defects might play a role in the development of neurological symptoms in Williams Syndrome patients. In this review, we discuss the properties of LIMK and CLIP family proteins, their function in the regulation of the actin and microtubule cytoskeletal systems, respectively, and the relationship with neurodevelopmental aspects of Williams Syndrome.

Actins↗
PubMed2003

Synthesis and supramolecular properties of trimethylene-bridged clips.

The novel trimethylene-bridged clips 3 and 4 have been synthesized by using repetitive stereoselective Diels-Alder reactions of the benzo- and naphthobismethylenenorbornenes 8 and 19 as dienes and norbornadiene 9 as bisdienophile, and subsequent dehydrogenation of the primary cyclobisadducts 10 and 20 by using 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ). Clips 3 and 4 serve as receptors for a variety of electron-deficient neutral and cationic aromatic substrates, comparable to the molecular tweezers 1 and 2. The thermodynamic parameters of the complex formation, K(a) and DeltaG, were determined by (1)H NMR titration experiments and, in the case of the highly stable complex TCNB 32@4, by the use of isothermal titration microcalorimetry. The finding that clip 4 forms more stable complexes than 3 can be explained by the larger van der Waals contact surfaces of the naphthalene sidewalls in 4 compared to the corresponding benzene systems in 3. In the complexes with 4 as receptor, the plane of each aromatic substrate molecule is calculated to be oriented almost parallel to the naphthalene sidewalls. However, in the complexes of tweezers 2, the substrate is usually oriented parallel to the central naphthalene spacer unit. Due to the more open topology of 4, most complexes were calculated to consist of two or more equilibrating noncovalent conformers.

Journal Article↗
PubMed2006

Use of the U-clip for microvascular anastomosis.

Microvascular anastomosis is a demanding skill requiring technical excellence and a thorough knowledge of anatomy and physiology. Every suture placed in a microvascular anastomosis should be considered critical as each has the potential to compromise the delicate reconstruction. As such, any device that can facilitate microvascular suture placement deserves thorough evaluation. The U-clip (Coalescent Surgical, Sunnyvale, CA) is such a device in that it eliminates the often time consuming process of tying knots. We evaluated use of the U-clip in microvascular anastomosis of a 1.5 mm artery. We found the U-clip to offer some advantages including ease of use, traditional feel of directed suture placement (as compared to couplers), and elimination of time needed for knot tying. Its shortcomings include size (in diameter, the "pop-off" section of the device appears larger than standard 8-0 suture), the significant force required to "pop-off" the device and difficulty removing the device.

Adult↗