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At least 163 records · Page 9Linked to original sources
PubMed2000

Regulation of the renal endothelin system in the two-kidney, one clip renal hypertensive rat.

Renovascular hypertension in the two-kidney, one clip (2K1C) model is characterized by initially elevated angiotensin-II (A-II) plasma concentrations, caused by ischemia in the clipped kidney and shear stress in the nonclipped kidney. These features are known stimuli of the endothelin (ET) system. The aim of this study was to analyze whether the renal ET system is activated in 2K1C renal hypertension in the rat. Wistar Kyoto rats (9 weeks old) were randomly assigned to four groups. Groups 1 and 3 underwent renal artery clipping, groups 2 and 4 were sham-operated. Groups 1 and 2 were used for analysis at 10 days after clipping, groups 3 and 4 12 weeks after clipping. We measured immunoreactive ET-1 renal tissue concentration as well as the ET(A)- and ET(B)-receptor density and affinity in renal cortex and medulla. We detected an increased immunoreactive ET-1 tissue concentration compared to the sham-operated control in the renal cortex of the nonclipped kidney 10 days (25.6 +/- 12.0 pg/g vs 12.5 +/- 5.0, 1 pg/g; p < 0.05) and in the renal cortex of the clipped kidney 90 days after clipping (92.4 +/- 47 pg/g vs 22.9 +/- 21 pg/g; p < 0.05), An increased ET(A)-receptor density was revealed in the renal medulla of the clipped kidney 10 days (624 +/- 130 fmol/mg vs 276 +/- 68 fmol/mg; p < 0.05) and 90 days (859 +/- 131 fmol/mg vs 493 +/- 93 fmol/mg; p < 0.05) after clipping. There were no differences in ET(B)-receptor density or binding affinity of either ET(A)- or ET(B)-receptors. In the 2K1C rat model of renovascular hypertension the renal ET system is activated. This activation is time-dependent and also dependent on the specific pathophysiological condition (clipped vs nonclipped). Increased ET-1 tissue concentration and upregulation of ET(A)-receptor density might lead to a synergistic activation of the ET system.

Animals↗
PubMed1997

Tissue marking clip for stereotactic breast biopsy: initial placement accuracy, long-term stability, and usefulness as a guide for wire localization.

PURPOSE: To determine initial placement accuracy, long-term stability, and usefulness as a guide for wire localization for metallic marker clips placed percutaneously after stereotactic breast biopsy. MATERIALS AND METHODS: One hundred forty-nine marker clips were placed percutaneously with a straight-needle or through-probe method, and clip positions were measured. The locations of 31 marker clips were followed up from deployment to first follow-up mammography. Thirty-six biopsy sites with marker clips were excised surgically and examined; 18 of these marker clips were targets for wire localization. The locations of 22 benign lesions were measured over time to calibrate the measurement system. RESULTS: Baseline variability was 8 mm. Initial marker clip deployment averaged 5 mm above baseline from the center of the target lesion (P < or = .01). Compared with baseline variability, marker clips remained in place from initial deployment to first imaging follow-up (mean, 8.6 months). Potentially clinically meaningful misplacement rates (deployment > 24 mm from target lesion center) were 7% for the through-probe method and 11% for the straight-needle method (not significantly different; P = .33). CONCLUSION: The marker clips appear to be useful targets for wire localization when the entire target lesion is removed at directional, vacuum-assisted breast biopsy. Upright, two-view mammography is recommended after deployment of the marker clip to document location.

Adult↗
PubMed2001

Metallic clip deployment during stereotactic breast biopsy: retrospective analysis.

PURPOSE: To determine the visibility of presumably excised lesions on screen-film mammograms obtained after biopsy and to determine the accuracy of clip deployment on the basis of measurements obtained on routine pre- and postbiopsy mammograms. MATERIALS AND METHODS: One hundred eleven cases of core-needle biopsy with clip deployment were reviewed. In each, the type of lesion, lesion location, and biopsy approach were recorded. Pre- and postbiopsy images were reviewed, and the distance between the clip and biopsy site was measured. Postbiopsy images were reviewed to determine whether the targeted lesion remained visible. RESULTS: In 62 (56%) cases, the clip was located within 5 mm of the target on postbiopsy images (craniocaudal and mediolateral), while in 18 (16%), the clip was within 6-10 mm on one projection. However, 31 (28%) clips were more than 1 cm from the target on at least one postbiopsy image. Of the 111 cases, 39 (35%) were malignant or atypical and required excision. Of these, 18 (46%) had clips at least 1 cm from the targeted lesion on at least one projection. CONCLUSION: Metallic clips placed during core-needle breast biopsy are intended to mark the biopsy site when the visible lesion is excised, in case additional biopsy is required. The data suggest that the position of metallic clips placed during stereotactic core-needle biopsy may differ substantially from the location of the biopsy site. Postbiopsy mammography should be performed in two orthogonal planes to document clip position relative to the biopsy site.

Biopsy, Needle↗
PubMed2006

Direct costs of surgical clipping and endovascular coiling of unruptured intracranial aneurysms.

BACKGROUND: Unruptured intracranial aneurysms can be preventively treated by surgical clipping or endovascular coiling. We determined in detail the costs of these treatments. METHODS: We included patients who were treated for an unruptured aneurysm between 1997 and 2003. Patients coiled in this period were matched with clipped patients according to the year of treatment, age and gender. Considering clipping and coiling, we compared all pre-admission costs of diagnostic procedures, all costs of treatment, and costs during follow-up including standard angiographic control examinations at 6 and 18 months after coiling. Costs were calculated as the product of the used resources and the costs of these resources. RESULTS: The mean price for clipping was EUR 8,865.42 and that for coiling EUR 10,370.29. The difference was mainly determined by the higher material costs of coiling (EUR 5,300) compared with clipping (EUR 690). Costs of clipping were mainly determined by the need for intensive care facilities (1.2 days after clipping and 0 days after coiling) and the length of hospital stay (10.5 days after clipping and 3.4 days after coiling). After bootstrapping the data, costs of coiling were on average EUR 1,553 (95% confidence interval: EUR 1,539-1,569) higher than those of clipping. CONCLUSIONS: For unruptured intracranial aneurysms, direct in-hospital costs of coiling are on average higher than those of clipping, mostly because of the more expensive coils.

Adult↗
PubMed2004

Effect of clipping, craniotomy, or intravascular coiling on cerebral vasospasm and patient outcome after aneurysmal subarachnoid hemorrhage.

OBJECTIVE: Although several recent studies have suggested that the incidence of vasospasm after aneurysmal subarachnoid hemorrhage is lower in patients undergoing aneurysmal coiling as compared with clipping, other studies have had conflicting results. We reviewed our experience over 8 years and assessed whether clipping, craniotomy, or coiling affects patient outcomes or the risk for vasospasm. METHODS: We included 515 patients with aneurysmal subarachnoid hemorrhage, identified prospectively from November 2000 to February 2003 (243 patients) and retrospectively from November 1995 to October 2000 (272 patients), by using International Classification of Diseases, 9th Revision, codes for subarachnoid hemorrhage. We classified patients as follows: clipping (413 patients), coiling (79 patients), and craniotomy (436 patients, including all 413 patients who underwent clipping plus 23 who underwent coiling as well as craniotomy for various reasons). We studied four outcome measures: total vasospasm, symptomatic vasospasm, poor outcome (modified Rankin score 3-6), and in-hospital mortality. To assess the risk of total vasospasm and symptomatic vasospasm, we performed multivariate regression analyses adjusting for age, Fisher grade, Hunt and Hess grade, aneurysm location (anterior versus posterior circulation), and aneurysm treatment modality. To assess the risk for poor outcome and in-hospital mortality, we adjusted for all the above variables as well as for total and symptomatic vasospasm. RESULTS: In the clipping group there was 63% total vasospasm and 28% symptomatic vasospasm; in the coiling group there was 54% total vasospasm and 33% symptomatic vasospasm; and in the craniotomy group there was 64% total vasospasm and 28% symptomatic vasospasm. In the multivariate analysis, age <50 years (P = 0.0099) and Fisher Grade 3 (P < 0.00001) predicted total vasospasm, and Fisher Grade 3 (P < 0.000001) and Hunt and Hess Grade IV or V (P = 0.018) predicted symptomatic vasospasm. Predictors of poor outcome were age >or=50 years (P < 0.0001), Fisher Grade 3 (P = 0.0072), Hunt and Hess Grade IV or V (P < 0.00001), symptomatic vasospasm (P < 0.0001), and coiling (P = 0.0314 versus clipping and P = 0.045 versus craniotomy). Predictors of in-hospital mortality were age >or= 50 years (P = 0.0030), Hunt and Hess Grade IV or V (P = 0.0001), symptomatic vasospasm (P < 0.00001), and coiling (P = 0.008 versus clipping and P = 0.0013 versus craniotomy). There was no significant difference in total vasospasm or symptomatic vasospasm when patients who underwent clipping or craniotomy were compared with patients who underwent coiling. In patients with Hunt and Hess Grade I to III ("good grade"), clipping and craniotomy were associated with better outcome and less in-hospital mortality, but there was no difference in total vasospasm or symptomatic vasospasm versus coiling. In patients with Hunt and Hess Grade IV or V ("poor grade"), there was no difference in any outcome measure among the treatment groups. CONCLUSION: In a single-center, retrospective, nonrandomized study, performance of clipping and/or craniotomy had significantly better outcome and lower mortality at discharge than coiling in good-grade patients but had no effect on total vasospasm or symptomatic vasospasm in good- or poor-grade patients.

Craniotomy↗
PubMed2005

Introducing a freely accessible internet database for identification of cerebral aneurysm clips to determine magnetic resonance imaging compatibility.

OBJECTIVE: Knowledge of the magnetic properties of cerebral aneurysm clips in patients undergoing magnetic resonance imaging (MRI) is imperative. In daily practice, however, it is often impossible to derive this information from previous medical records. The aim of this study was to develop a freely accessible internet database to identify unknown cerebral aneurysm clips on the basis of conventional x-ray images of the cranium and to provide reliable information about their magnetic properties to allow safe MRI investigations in these patients. METHODS: The 17 most commonly used clip series of the past 50 years were selected. The ferromagnetic properties of 47 example clips were examined by means of the Food and Drug Administration-approved "deflection angle test." An HTML-based database has been developed using standard x-ray images in two planes and photographs of the clips. Furthermore, details about alloy, ferromagnetic properties, MRI compatibility, year of construction, and other characteristics identifiable on x-rays were included. RESULTS: Seven aneurysm clips (of four clip models) were judged to be not MRI-compatible. The database named "ClipFinder" allows easy identification of cerebral aneurysm clips on standard cranial x-rays by comparing the films with the databank images supported by information on unique features of the clip design. CONCLUSION: On exemplary applications, ClipFinder provides a fast and easy-to-use database to identify unknown cerebral aneurysm clips via the internet and determine their MRI compatibility. The reliability of the identification system needs to be further evaluated in clinical practice before it can be recommended for widespread use.

Contraindications↗
PubMed2006

Orthogonal interlocking tandem clipping technique for the reconstruction of complex middle cerebral artery aneurysms.

OBJECTIVE: Complex aneurysms arising at the middle cerebral artery (MCA) bifurcation frequently present a microsurgical challenge to effectively obliterate while maintaining patency of the distal MCA branches. These aneurysms are often multilobed, with their long axis aligned with the long axis of the M1 trunk, placing the dome of the aneurysm in the surgeons' line of sight, preventing an unobstructed view of the entire bifurcation and proximal M1 segment. MCA aneurysms often have a broad neck, splaying the bifurcation. An orthogonal interlocking tandem clipping technique, maximizing the use of fenestrated aneurysm clips, is presented as a means to completely obliterate the aneurysm and simultaneously "reconstruct" the MCA bifurcation. CLINICAL PRESENTATIONS AND INTERVENTION: Fifteen complex MCA aneurysms were treated using an interlocking tandem clipping technique. In its simplest application, the blades of the initial aneurysm clip are incorporated into the fenestration of the second clip. Obliteration of the residual aneurysm is achieved with the blades of the second, fenestrated clip. RESULTS: Satisfactory aneurysm obliteration and reconstruction of the MCA bifurcation was achieved in all cases using this technique, with excellent neurological outcomes. CONCLUSION: Morphologically complex multilobed MCA aneurysms can be effectively clipped with "reconstruction" of the normal vascular anatomy using a tandem interlocking clipping technique. A fenestrated clip is used to incorporate the blades of the initial clip, while obliterating the remainder of the aneurysm.

Adult↗
PubMed2006

Application of a new suture material called the U-Clip for composite and sequential grafting with off-pump coronary bypass surgery.

BACKGROUND: The U-Clip was found to facilitate the interrupted anastomosis of coronary artery bypass grafts (CABG). This device may be beneficial especially in multivessel off-pump CABG (OPCAB) using composite grafts or sequential anastomosis. The aim of this study was to evaluate our early clinical experience using the U-Clip in OPCAB cases. METHODS: This retrospective study included 118 patients who underwent off-pump CABG between 2001 and 2004. The mean age of the 91 men and 27 women was 69.5 +/- 8.0 years (range, 47-85). The U-Clip was adopted for sewing 73 proximal ends of the free graft to the side or end of the inflow conduit to prepare the composite graft. The U-Clip was also applied to 112 distal anastomoses, especially to the side-to-side anastomosis of the sequential graft. RESULTS: Hospital mortality rate was 0.8% (1/118). The early patency rate of distal anastomoses using the U-Clip was 95% (96/101). The early patency rate of proximal anastomoses using the U-Clip was 98.4% (62/63). Interim angiography was performed in 12 patients (range, 3.8-42 months; average, 16 months). In these 12 patients, a total of 8 proximal anastomoses of conduits using the U-Clip were all patent without stenosis. The patency rate of a total of 10 distal anastomoses in the 12 patients using the U-Clip was 100%. CONCLUSIONS: The U-Clip-interrupted anastomosis enables a safe, definite, and rapid end-to-end or end-to-side connection of arterial grafts. We therefore consider the U-Clip to be a useful suture material especially for multivessel OPCAB using multiple arterial grafts.

Aged↗
PubMed2002

Prediction of recurrence and prognosis in patients with hepatocellular carcinoma after resection by use of CLIP score.

AIM: The survival time of patients with hepatocellular carcinoma (HCC) after resection is hard to predict. Both residual liver function and tumor extension factors should be considered. A new scoring system has recently been proposed by the Cancer of the Liver Italian Program (CLIP). CLIP score was confirmed to be one of the best ways to stage patients with HCC. To our knowledge, however, the literature concerning the correlation between CLIP score and prognosis for patients with HCC after resection was not published. The aim of this study is to evaluate the recurrence and prognostic value of CLIP score for the patients with HCC after resection. METHODS: A retrospective survey was carried out in 174 patients undergoing resection of HCC from January 1986 to June 1998. Six patients who died in the hospital after operation and 11 patients with the recurrence of the disease were excluded at 1 month after hepatectomy. By the end of June 2001, 4 patients were lost and 153 patients with curative resection have been followed up for at least three years. Among 153 patients, 115 developed intrahepatic recurrence and 10 developed extrahepatic recurrence, whereas the other 28 remained free of recurrence. Recurrences were classified into early (< or =3 year) and late (>3 year) recurrence. The CLIP score included the parameters involved in the Child-Pugh stage (0-2), plus macroscopic tumor morphology (0-2), AFP levels (0-1), and the presence or absence of portal thrombosis (0-1). By contrast, portal vein thrombosis was defined as the presence of tumor emboli within vascular channel analyzed by microscopic examination in this study. Risk factors for recurrence and prognostic factors for survival in each group were analyzed by the chi-square test, the Kaplan-Meier estimation and the COX proportional hazards model respectively. RESULTS: The 1-, 3-, 5-, 7-,and 10-year disease-free survival rates after curative resection of HCC were 57.2%, 28.3%, 23.5%, 18.8%, and 17.8%, respectively. Median survival time was 28, 10, 4, and 5 mo for CLIP score 0, 1, 2, 3, and 4 to 5, respectively. Early and late recurrence developed in 109 patients and 16 patients respectively. By the chi-square test, tumor size, microsatellite, venous invasion, tumor type (uninodular, multinodular, massive), tumor extension (< or = or >50% of liver parenchyma replaced by tumor), TNM stage, CLIP score, and resection margin were the risk factors for early recurrence, whereas CLIP score and Child-Pugh stage were significant risk factors for late recurrence. In univariate survival analysis, Child-Pugh stages, resection margin, tumor size, microsatellite, venous invasion, tumor type, tumor extension, TNM stages, and CLIP score were associated with prognosis. The multivariate analysis by COX proportional hazards model showed that the independent predictive factors of survival were resection margins and TNM stages. CONCLUSION: CLIP score has displayed a unique superiority in predicting the tumor early and late recurrence and prognosis in the patients with HCC after resection.

Adolescent↗
PubMed2000

An evaluation of the relevance of routine DNA typing of fingernail clippings for forensic casework.

DNA extracted from fingernail clippings of victims in forensic cases is a possible source of DNA from the perpetrator in cases where victims struggled or defended themselves. The source of this DNA on a victim's fingernails could possibly originate from contact with the suspect's blood, saliva, semen or scratched skin. In this technical note we evaluate the relevance of routine DNA typing of fingernail clippings in the forensic biology laboratory when, in real casework, normally only small quantities of nail material is sent. This was carried out by extracting DNA from fingernail clippings from a number of volunteers, before and after aggressively scratching other volunteers. No blood was drawn from the scratching, but skin flakes were observed under the nails before cutting and subsequent DNA typing. The DNA extracted was then typed using the STR systems: HUMTHO1, HUMTPOX and HUMCSF1PO (CTT triplex) and the system of D1S80. These profiles were compared with profiles achieved by similar typing of buccal swabs as a reference from each volunteer. In this study, the profile detected from each volunteer's clippings was the same before and after scratching, and matched the profile of the corresponding volunteer as defined by typing each volunteer's reference buccal swab. Fingernail clippings that are sent to our lab in actual casework are usually so small that additional treatment by swabbing or removing debris from below the clipping is not possible. For this reason, in this simulation the entire clippings were used for DNA extraction, to maximize the possibility of finding an additional profile. In conclusion, the findings from this study show that although the profiles obtained when typing fingernail clippings are those of the donors themselves, we suggest that typing of fingernail clippings should be carried out in forensic cases only when relevant. We would suggest that fingernail clippings not be routinely sent to the biology laboratory as items of evidence to be tested.

Forensic Medicine↗
PubMedDate not supplied

Effects of attachment clips on occlusal force transmission in removable implant-supported overdentures and cantilevered superstructures.

Attachment clips are commonly used to provide retention for removable implant-supported overdentures. In this study, the effects of attachment clips on occlusal force transmission in four implant-supported overdentures with cantilever extensions were investigated using beam theory. Distributions of moments and of forces in overdenture, clips, cantilevered superstructure, and implants were calculated as functions of position, number, and stiffness of attachment clips. Three-, four-, and five-attachment clip configurations were analyzed. Results showed that maximum bending moments and forces in all components are strong functions of position, number, and retention of attachment clips, while the effects of attachment clip stiffness are negligible. Increasing the number of attachment clips from three to five results in a significant decrease of maximum bending moments in the superstructure and implant. For a wide range of attachment clip positioning, the maximum tensile force on the implants is as high as half the applied load. At least one attachment clip for all configurations is also subjected to tensile force, which can cause it to slip out from the superstructure and increase maximum bending moment in the superstructure and implants.

Acrylic Resins↗
PubMed1995

The ability of laparoscopic clips to withstand high intraluminal pressure.

OBJECTIVE: To determine if commercially available clips for laparoscopic surgery become displaced with high intraluminal pressures. DESIGN: In vivo model in which the splenic, renal, and mesenteric vessels together with the gallbladder of anesthetized living pigs were individually occluded using titanium and absorbable clips and then subjected to pressures of 300 mm Hg; and in vitro model in which the procedure was repeated on freshly removed human gallbladders with the attached segment of cystic duct. INTERVENTION: The intraluminal pressure of the occluded segment was increased until (1) the clip was released, (2) the vessel burst, or (3) the predetermined pressure (300 mm Hg) was obtained. RESULTS: A total of 90 clips were examined. No clip could be displaced from any porcine vessel at intraluminal pressures of up to 300 mm Hg. One vessel burst before the predetermined pressure was obtained, the clips remaining intact. Clips placed on the porcine and human models also could not be displaced by a pressure of 300 mg Hg. CONCLUSION: Commercially available titanium and absorbable clips do not disrupt when subjected to high intraluminal pressures. Postoperative bile leaks are more likely to result from necrosis of the cystic duct than displacement of the clip by the pressure within the biliary system.

Animals↗
PubMed2006

Dynamics in host-guest complexes of molecular tweezers and clips.

The dynamics in the host-guest complexes of the molecular tweezers 1 a,b and clips 2 a,b with 1,2,4,5-tetracyanobenzene (TCNB, 3) and tropylium tetrafluoroborate (4) as guest molecules were analyzed by temperature-dependent 1H NMR spectroscopy. The TCNB complexes of tweezers 1 a,b were found to be particularly stable (dissociation barrier: DeltaG(++)=16.8 and 15.7 kcal mol(-1), respectively), more stable than the TCNB complexes of clips 2 a,b and the tropylium complex of tweezer 1 b (dissociation barrier: DeltaG(++)=12.4, 11.2, and 12.3 kcal mol(-1), respectively). A detailed analysis of the kinetic and thermodynamic data (especially the negative entropies of activation found for complex dissociation) suggests that in the transition state of dissociation the guest molecule is still clipped between the aromatic tips of the host molecule. The 1H NMR analysis of the TCNB complexes 3@1 b and 3@2 a at low temperatures (T<-80 degrees C) showed that 3 undergoes fast rotation inside the cavity of tweezer 1 b or clip 2 a (rotational barrier: DeltaG( not equal)=11.7 and 8.3 kcal mol(-1), respectively). This rotation of a guest molecule inside the host cavity can be considered to be the dynamic equilibration of noncovalent conformers. In the case of clip complex 3@2 a the association and rotational barriers are smaller by DeltaDeltaG(++)=3-4 kcal mol(-1) than those in tweezer complexes 3@1 a,b. This can be explained by the more open topology of the trimethylene-bridged clips compared to the tetramethylene-bridged tweezers. Finally, the bromo substituents in the newly prepared clip 2 b have a substantial effect on the kinetics and thermodynamics of complex formation. Clip 2 b forms weaker complexes with (TCNB, 3) and tetracyanoquinodimethane (TCNQ, 12) and a more stable complex with 2,4,7-trinitrofluoren-9-ylidene (TNF, 13) than the parent clip 2 a. These results can be explained by a less negative electrostatic potential surface (EPS) inside the cavity and a larger van der Waals contact surface of 2 b compared to 2 a. In the case of the highly electron-deficient guest molecules TCNB and TCNQ the attractive electrostatic interaction is predominant and hence responsible for the thermodynamic complex stability, whereas in the case of TNF with its extended pi system, dispersion forces are more important for host-guest binding.

Journal Article↗
PubMed1996

Motion and image artifacts of various intracranial aneurysm clips in a magnetic field.

Deflection angles of 36 types of Sugita intracranial aneurysm clips (Elgiloy), 2 types of Yasargil clips (Phynox), a Kirschner chip (SUS316) and a silver clip were examined by suspending each in a 1.5-tesla MRI (TOSHIBA MRT-200/FXII). Image artifacts of 5 types of intracranial aneurysm clips were also studied quantitatively with respect to their ratio of artifact/actual clip size using a spin-echo sequence with T1-weighted (Time of repetition (TR) = 500 ms, Time of echo (TE) = 20 ms) and T2-weighted (TR = 2000 ms, TE = 80 ms) images. All the Sugita clips from mini type to long type showed a deflection angle of less than 1.0 degree, the Yasargil clips less than 2.0 degrees, the Kirschner chip less than 6.0 degrees, and the silver chip did not move at all. Both brands of clips are therefore suitable for intracranial applications. The artifact size was directly proportional to the clip size and weight, though the ratio of artifact/actual width tended to decrease proportionately as the actual size and weight increased. The ratio of the width seemed slightly bigger than that of the length, but the difference did not reach statistical significance. There was no significant difference in the ratio of image artifacts/clip size between T1- and T2-weighted images.

Artifacts↗
PubMed2005

[Clip marker placement following MR-guided vacuum biopsy of the breast].

PURPOSE: The purpose of our study was to determine the placement accuracy, usefulness as a guide for wire localization, and long-term stability of tissue marker clips following MR-guided vacuum-assisted biopsy (VB) of breast lesions. METHODS: During a 2-year period, MR-guided VB with an 11-gauge device was performed in 79 lesions. In 26 lesions a marker clip was placed at the biopsy site. RESULTS: In 18 cases, the clip was shown to be closely adjacent to the lesion on post-interventional MR images. In seven cases in which minor bleeding occurred, the clip dislocated (< or =15 mm) in the direction of the needle pathway. In one case dislocation in the dorsal direction (< or =5 mm) was observed. In eight cases with a malignant or borderline histology according to the VB, the marker clips served as targets for mammographically guided wire localization. In all of those patients, histology results derived from open surgery confirmed those of VB. Eighteen patients with benign findings according to the VB were followed up 6 months later. Among these cases we found a significant displacement of the marker clip in one case (3 cm). The clip generally caused a round artifact (diameter of 9+/-2 mm). In two cases it was not possible to determine whether the lesion had been removed completely or was just behind the artifact caused by the clip. CONCLUSION: Based on our results, clip marker placement following MR-guided vacuum biopsy should be called into question due to the possibility of masking the lesion by a metallic artifact and because of possible dislocation.

Adult↗
PubMed1997

Torque-velocity relationship during cycle ergometer sprints with and without toe clips.

The torque-velocity relationship in cycling has been studied during all-out sprints (n = 6 subjects) with and without toe clips on an electronic Lode ergometer with strain gauges, to estimate the importance of the expected decrease in torque, velocity and power output. As previously found with different cycling protocols, the torque-velocity relationship was linear for all-out sprints with toe clips. A similar relationship was observed when cycling without toe clips but the torque-velocity relationship was inflected downwards at low or high velocities in several subjects who were not regular cyclists. The pulling action during the rise of the pedal at low velocities cannot explain why the torque-velocity relationship is not hyperbolic for cycling exercises with toe clips because similar relationships were observed without toe clips. The maximal power output was significantly higher during cycling with toe clips (782 W vs 668 W, P < 0.05), probably because of the pulling action at low and medium velocities as indicated by the higher value of the extrapolated maximal torque T0 (138 N x m vs 122 N x m, P < 0.05). In contrast, the maximal extrapolated velocity, V0 and peak velocity were not significantly improved by the use of toe clips. The comparison of the angle-torque patterns at low and high velocities suggested that the kinetic energy of the legs can be transformed into power output when cycling without toe clips as well as it can when cycling with toe clips.

Adult↗
PubMed1984

Avoidance of artifacts on computerized tomograms by selection of appropriate surgical clips.

Surgical clips (metallic or plastic) are frequently used for hemostasis and tumor marking. This study evaluated the radiographic and computerized tomographic appearance of different clips and their relative interference with computerized tomographic scans. Metallic clips (stainless steel, tantalum, and titanium) can all be seen on plain radiographs. Tantalum clips caused extensive distortion on computerized tomographic scans which would interfere with scan interpretation. Both stainless steel and titanium clips resulted in much less artifact and interference on computerized tomographic scans. Recent studies have suggested that there may be some risk of torsion of stainless steel clips in nuclear magnetic resonance scanners resulting in tissue damage. Absorbable plastic clips cannot be seen on plain film but are visualized on computerized tomographic scans and do not appear to cause scan artifact. Overall, we recommend the use of either titanium hemostatic clips when tumor marking on plain film is required or plastic clips when tumor marking is less important.

Evaluation Studies as Topic↗
PubMed2004

Randomized trial to compare perioperative outcomes of Filshie clip vs. Pomeroy technique for postpartum and intraoperative cesarean tubal sterilization: a pilot study.

OBJECTIVE: To compare, by conducting a randomized trial, Filshie clip and Pomeroy techniques for postpartum and intrapartum cesarean sterilizations in a United States teaching hospital with respect to surgeon preference and perioperative outcomes. METHOD: Thirty-two obstetric patients consented for sterilization were randomized to Pomeroy technique or Filshie clip placement. Following the surgical procedure, surgeons and operating room technicians completed a survey regarding their experience with the procedures and preference. Patient demographic data, time for procedure and follow-up visits were obtained by chart review. RESULTS: For most postpartum sterilizations, the mean duration of the procedure was almost 7 min faster for the Filshie clip technique (p = 0.08); perioperative outcomes were equivalent (p = 0.05). Application of the Filshie clip was rated easier than Pomeroy suture application and, overall, the Filshie clip sterilization procedure was rated less difficult (p = 0.03). Seventy percent of surgeons preferred the Filshie clip technique and would choose it if only one postpartum sterilization method was available. CONCLUSION: For obstetric sterilization, surgeons preferred the Filshie clip over the Pomeroy technique. In addition, operating time was shorter for the Filshie clip. This pilot study suggests that use of the Filshie clip technique has the potential to establish a new standard of care for postpartum and intrapartum cesarean sterilization.

Adult↗