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At least 1,063 records · Page 59Linked to original sources
PubMed1983

[Late results in fallopian tubes studies on the Bleier clip].

We report on 243 patients with sterilisation by the Bleier Clip. 234 patients were operated by coeliotomia posterior. 9 cases were sterilized in combination with Caesarean section. In 4 of 243 women we observed pregnancies during the follow-up period (failure rate = 16%). The mean time of the 4 conceptions after operation was 43 months. This result shows that the primary cause was not the operation technique but the systemic failure of the Bleier Clip. In cases with controls by hysterosalpingography all Fallopian tubes were occluded, 84% together with a sactosalpinx.

Cesarean Section↗
PubMed1991

[Pathology of the corneal endothelium in bullous keratopathy following iris clip lens implants].

12 patients developed pseudophakic bullous keratopathy 2 to 7 years following i.c. cataract-extraction with implantation of 4-loop iris clip lenses necessitating perforating keratoplasty. To study the pathogenesis of pseudophakic bullous keratopathy the corneal endothelium of the excised button was investigated light-microscopically after vital staining of the endothelium. Additionally the surface of the explanted intraocular lenses were examined by the method of Wolter. The result is a central cell density of the excised corneal buttons between 179 and 867 cells/mm2. Large cell-free areas were always found indicating that a disturbance of the endothelial barrier function is the major reason for corneal decompensation. A relation between inflammatory cell deposits on the IOL-surfaces and the endothelial decompensation was not apparent. As the main reason for endothelial decompensation a chronical mechanically induced endothelial cell loss is supposed leading to disturbances of the endothelial barrier function. To prevent a repeated corneal decompensation it is recommended to remove iris-clip-lenses during the procedure of perforating keratoplasty.

Aged↗
PubMed1999

Coiling of recurrent and residual cerebral aneurysms after unsuccessful clipping.

We treated four patients with 3 recurrent and 1 residual aneurysm after surgical clipping by using Guglielmi detachable coils (GDCs). Three subjects presented after a second subarachnoid hemorrhage (SAH) occurring between 10 and 25 years after the first bleeding. Early postoperative angiography of the fourth patient showed an incompletely clipped aneurysm. In three poor grade patients we observed one good outcome, one fair result and one death due to the sequelae of SAH. One good grade patient remained in excellent condition postoperatively. Three aneurysms were totally occluded and in one a more than 90% occlusion was achieved with GDCs. We consider the treatment with GDC a viable alternative to reoperation in all patients with recurrent or residual aneurysms following failed attempt at surgical obliteration.

Adult↗
PubMed1984

Intraoperative topical nimodipine after aneurysm clipping.

The lipophilic calcium antagonist Nimodipine (Bayer Pharma , Wuppertal ) was administered during aneurysm operations in 40 patients with ruptured intracranial aneurysm. Immediately after clipping of the aneurysm, a 2.4 X 10(-5) M solution of Nimodipine in 18 ml of Ringer's solution was injected into the subarachnoid space near the site of aneurysm clipping. Arterial vessels regularly dilated and spastic portions resumed their normal diameters. Since it is known from experimental work, that Nimodipine has stronger dilator capacity than papaverine and acts at least for several hours, two conclusions are drawn from the present preliminary study: Pre-operative vasospasm seen on angiograms is no longer a contraindication to early operation because spasm detected intraoperatively can be effectively treated. The long-lasting effect of Nimodipine prevents ischaemic complications in the first few days after operation and thereby seems to exert a protective effect against the onset of severe symptomatic vasospasm.

Administration, Topical↗
PubMed1980

The broken clip.

A case of a broken clip demonstrated by radiography is presented. As angiography showed no filling of the aneurysm, further operation was not considered necessary. The cause of the fracturing of the clip remains unknown.

Female↗
PubMed1980

Clip stenosis--a hazard of incorrectly prepared saphenous vein bypass grafts to coronary arteries.

During the routine review of control follow-up cinéangiograms taken of patients after aorto-coronary bypass grafting, the authors noted a number of vein graft stenoses of varying severity. All stenoses were in the segment of vein away from the aortic or coronary anastomoses, but were clearly at the site of a steel clip used to occlude side branches during preparation of the vein graft. The incidence was too high to be related to chance, and in some cases the intrusion of the clip upon the lumen was obvious. Suggestions are made to eliminate the occurrence of this iatrogenic stenosis.

Cineangiography↗
PubMed1995

Combined microneurosurgical and endovascular "trapping-evacuation" technique for clipping proximal paraclinoidal aneurysms.

A method is described in which a combined endovascular and microneurosurgical approach is used for clipping aneurysms of the proximal paraclinoidal segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double lumen ballon catheter, clip application to large and critically located aneurysms is facilitated applying decompression to the trapped arterial segment under intraoperative somatosensory-evoked potential (SEP) monitoring.

Journal Article↗
PubMed1993

Nonpenetrating clips successfully replacing sutures in base of skull surgery.

Reconstructive challenges engendered by skull base surgery are critical determinants of outcome. A novel nonpenetrating, arcuate-legged clip has proven to be both technically and biologically effective for management of these difficult closures. Clips have facilitated reconstructions associated with the surgical management of eight skull base cases: leiomyosarcoma of the orbit, middle fossa, ptyergopalatine fossa, two meningiomas (petrotentorial, cavernous sinus), vagus nerve paraganglioma, complex traumatic orbital dural tear, and one basilar and two vertebral artery aneurysms.

Journal Article↗
PubMed2001

Experimental endoscopic repair of gastric perforations with an omental patch and clips.

BACKGROUND: The omental patch is a standard surgical treatment of gastroduodenal ulcer perforation. This is a report of an experimental method for endoscopic repair of anterior gastric perforations with an omental patch developed by using a porcine model. METHODS: A standardized gastric perforation was created in 10 pigs. The omentum was pulled into the gastric lumen and fixed endoscopically to the muscularis propria layer of the stomach with metallic clips. RESULTS: The postoperative course was normal in 9 animals. An ulcer was evident at the site of repair at follow-up endoscopy. At autopsy, the omentum was adherent to the external side of gastric wall. One animal died with peritonitis, presumably because the muscularis propria layer could not be seen during the procedure, and the clips attached the omentum only to the mucosa. CONCLUSIONS: Endoscopic repair with an omental patch appears to be an effective procedure for closure of gastric perforations.

Animals↗
PubMed2001

Specific treatment of autoimmunity with recombinant invariant chains in which CLIP is replaced by self-epitopes.

The invariant chain (Ii) binds to newly synthesized MHC class II molecules with the CLIP region of Ii occupying the peptide-binding groove. Here we demonstrate that recombinant Ii proteins with the CLIP region replaced by antigenic self-epitopes are highly efficient in activating and silencing specific T cells in vitro and in vivo. The Ii proteins require endogenous processing by antigen-presenting cells for efficient T cell activation. An Ii protein encompassing the epitope myelin basic protein amino acids 84-96 (Ii-MBP84-96) induced the model autoimmune disease experimental allergic encephalomyelitis (EAE) with a higher severity and earlier onset than the peptide. When applied in a tolerogenic manner, Ii-MBP84-96 abolished antigen-specific T cell proliferation and suppressed peptide-induced EAE more effectively than peptide alone. Importantly, i.v. administration of Ii proteins after EAE induction completely abrogated the disease, whereas peptides only marginally suppressed disease symptoms. Ii fusion proteins are thus more efficient than peptide in modulating CD4(+) T cell-mediated autoimmunity, documenting their superior qualities for therapeutic antigen delivery in vivo.

Animals↗
PubMed2002

Prophenoloxidase-activating proteinase-2 from hemolymph of Manduca sexta. A bacteria-inducible serine proteinase containing two clip domains.

Proteolytic activation of prophenoloxidase in insects is a component of the host defense system against invading pathogens and parasites. We have purified from hemolymph of the tobacco hornworm, Manduca sexta, a new serine proteinase that cleaves prophenoloxidase. This enzyme, designated prophenoloxidase-activating proteinase-2 (PAP-2), differs from another PAP, previously isolated from integuments of the same insect (PAP-1). PAP-2 contains two clip domains at its amino terminus and a catalytic domain at its carboxyl terminus, whereas PAP-1 has only one clip domain. Purified PAP-2 cleaved prophenoloxidase at Arg(51) but yielded a product that has little phenoloxidase activity. However, in the presence of two serine proteinase homologs, active phenoloxidase was generated at a much higher level, and it formed covalently linked, high molecular weight oligomers. The serine proteinase homologs associate with a bacteria-binding lectin in M. sexta hemolymph, indicating that they may be important for ensuring that the activation of prophenoloxidase occurs only in the vicinity of invading microorganisms. PAP-2 mRNA was not detected in naive larval fat body or hemocytes, but it became abundant in these tissues after the insects were injected with bacteria.

Amino Acid Sequence↗
PubMed2005

Titanium hemostatic clip tailoring method to overcome vessel caliber discrepancy in interposition saphenous vein graft for carotid artery resection.

CONCLUSION: This method makes it possible to perform the ISVG simply and within a short time and, therefore, is very useful for shortening the duration to block circulation. OBJECTIVE: Complete excision of a malignant tumor which invades carotid artery walls essentially requires the resection and reconstruction of the carotid artery. In most cases, an interposition graft using a saphenous vein has been performed; however, the discrepancy in vessel caliber between the common carotid artery and the saphenous vein can complicate the surgical technique. We have introduced and evaluated a new titanium hemostatic clip tailoring method to overcome the vessel caliber discrepancy in interposition saphenous vein graft (ISVG) for carotid artery resection in the treatment of head and neck cancers. MATERIAL AND METHODS: After carotid artery resection, the calibers of the proximal common carotid artery and the vein were compared, and the size of the orifice of the common carotid artery was gradually reduced to a little larger than or the same as that of the vein using a titanium hemostatic clip. Subsequently, the common carotid artery was connected to the vein by means of anastomosis. The same method was also applied to the distal anastomosis site. Thereafter, the vessels were connected through the anastomosis, and circulation was restored by releasing a vascular clamp. Then, the redundant portion on the outside of the carotid artery was sutured by means of the blanket-edge suture method, using 6-0 Prolene. RESULTS: We employed this method in two patients with recurrent squamous cell carcinoma and neuroblastoma, respectively. The ISVG of these patients was found to maintain good patency at follow-up angiography after 1 year, and no specific vascular complications were observed.

Anastomosis, Surgical↗
PubMed1991

Influence of claw clipping, stocking density and feeding space on the incidence of scabby hips in broilers.

1. The aetiology of scabby hips was studied in broilers by scratching the skin with chicken claws, clipping the birds' claws and varying the effects of stocking density and food trough allocation. 2. Gentle scratching twice a week resulted in skin lesions that could not be distinguished from clinical scabby hips at slaughter. Interaction between birds appeared to be a prerequisite for the skin condition to develop. 3. Clipping of the claws at day 25 could almost completely prevent scabby hips at day 45 when the birds were slaughtered. 4. No positive correlation was found between feather condition and the severity of scabby hips at slaughter at day 45. 5. Decrease in stocking density and an increase in feeding space resulted in a reduction of skin lesions at day 25 and resultant scabby hips after slaughter.

Animals↗
PubMed2003

Yasargil-Phynox aneurysm clip: a simple and reliable device for making a peripheral nerve injury.

A great number of devices were used to make a peripheral nerve injury. In the scientific literature, experimental crush injuries have been usually created using forceps or hemostatic forceps, neither of which allows quantitative or standard application of compression. Therefore, we used a Yasargil-Phynox aneurysm clip to make a reliable and standardized peripheral nerve injury. The advantages and disadvantages of this clip were discussed. In particular, we think that standardization of the compression is necessary to compare interlaboratory results.

Animals↗
PubMed2005

Effects of renal denervation of the contralateral kidney on blood pressure and sodium and eicosanoid excretion in the chronic phase of two-kidney, one-clip renovascular hypertension in rats.

OBJECTIVE: To define the role of the renal nerves of the contralateral kidney in the maintenance of two-kidney, one-clip (2K-1C) renovascular hypertension in rats. MATERIAL AND METHODS: The contralateral kidney of 2K-1C rats was denervated 6 months after induction of hypertension and 4 weeks after nephrectomy of the clipped kidney. Blood pressure, sodium and potassium balance and eicosanoid excretion were measured. RESULTS: Denervation of the contralateral kidney induced normalization of blood pressure in post-Goldblatt hypertensive rats. This effect was not mediated by a negative sodium balance. Excretion of prostaglandin E2 and thromboxane B2 increased after denervation of the contralateral kidney in both post-Goldblatt hypertensive and post-Goldblatt normotensive rats, while urine extraction remained unaffected. CONCLUSION: Afferences from the contralateral kidney appear to participate in the maintenance of 2K-1C renovascular hypertension due to the activation of central mechanisms regulating blood pressure.

6-Ketoprostaglandin F1 alpha↗
PubMed1993

Pitfall in clipping of unruptured cerebral aneurysms: narrowing of the parent artery.

Two patients with unruptured cerebral aneurysms are presented, who were complicated by transient ischaemic neurological deficits after seemingly uneventful neck clipping. Postoperative angiography disclosed narrowing of the parent arteries. Arteriosclerotic thickening of the wall of the aneurysmal neck and the parent artery was presumed to be the cause of the narrowing. To minimize the operative morbidity in patients with unruptured aneurysms, the possibility of this phenomenon should always be borne in mind. Neck clipping procedures avoiding this pitfall are discussed.

Aged↗
PubMed2000

Outcome from poor grade aneurysmal subarachnoid haemorrhage--which poor grade subarachnoid haemorrhage patients benefit from aneurysm clipping?

Patients with poor grade aneurysmal subarachnoid haemorrhage (SAH) are associated with high mortality and morbidity, and hence are often treated conservatively. This study has set out to determine the outcome for all poor grade subarachnoid haemorrhage patients, and attempts to identify a subgroup with a more favourable prognosis. During a prospective audit of patients with aneurysmal SAH, patients of poor grade [World Federation of Neurological Surgeons (WFNS) IV (and not obeying commands) and V] were sedated, paralysed and ventilated for transfer to the Regional Neurosurgical Unit. Any intraventricular blood and/or hydrocephalus was treated by external ventricular drainage. Following a 24-h period for active blood gas, fluid and electrolyte resuscitation, patients were assessed after reversal of sedation. Selection for angiography and potential aneurysm surgery was restricted to those who showed a purposeful response to painful stimulation. Patients who could readily obey commands were not considered 'true' poor grade and were excluded from analysis. In 102 patients with 'true' poor grade SAH admitted between 1991 and 1997, the overall management outcome at 6 months was poor (favourable outcome 25%, mortality 67%). Following reversal of sedation, 55 patients demonstrated a purposeful response and proceeded to angiography, of whom 37 underwent clipping and three coiling of aneurysm. The outcome in this aneurysm treated subgroup was favourable in 53% (mortality 28%). If patients over the age of 65 years are excluded, the management outcome was favourable in 35% (mortality 58%), with those patients proceeding to clipping or coiling of aneurysms having a favourable outcome in 57% (mortality 27%). Patients over the age of 65 years with poor grade SAH had a favourable outcome in only 6% (mortality 85%). The mortality for poor grade SAH patients remains high. However, following resuscitation and correction of any acute hydrocephalus, a patient subgroup identified on simple clinical criteria can be identified who can expect a better outcome.

Adolescent↗