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Jugular Vein (jugular + vein)
Kinds of Jugular Vein Terms modified by Jugular Vein Selected AbstractsA Descriptive Comparison of Ultrasound-guided Central Venous Cannulation of the Internal Jugular Vein to Landmark-based Subclavian Vein CannulationACADEMIC EMERGENCY MEDICINE, Issue 4 2010Daniel Theodoro MD Abstract Objectives:, The safest site for central venous cannulation (CVC) remains debated. Many emergency physicians (EPs) advocate the ultrasound-guided internal jugular (USIJ) approach because of data supporting its efficiency. However, a number of physicians prefer, and are most comfortable with, the subclavian (SC) vein approach. The purpose of this study was to describe adverse event rates among operators using the USIJ approach, and the landmark SC vein approach without US. Methods:, This was a prospective observational trial of patients undergoing CVC of the SC or internal jugular veins in the emergency department (ED). Physicians performing the procedures did not undergo standardized training in either technique. The primary outcome was a composite of adverse events defined as hematoma, arterial cannulation, pneumothorax, and failure to cannulate. Physicians recorded the anatomical site of cannulation, US assistance, indications, and acute complications. Variables of interest were collected from the pharmacy and ED record. Physician experience was based on a self-reported survey. The authors followed outcomes of central line insertion until device removal or patient discharge. Results:, Physicians attempted 236 USIJ and 132 SC cannulations on 333 patients. The overall adverse event rate was 22% with failure to cannulate being the most common. Adverse events occurred in 19% of USIJ attempts, compared to 29% of non,US-guided SC attempts. Among highly experienced operators, CVCs placed at the SC site resulted in more adverse events than those performed using USIJ (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.05 to 3.39). Conclusions:, While limited by observational design, our results suggest that the USIJ technique may result in fewer adverse events compared to the landmark SC approach. ACADEMIC EMERGENCY MEDICINE 2010; 17:416,422 © 2010 by the Society for Academic Emergency Medicine [source] Patency and Flow of the Internal Jugular Vein After Functional Neck Dissection,THE LARYNGOSCOPE, Issue 1 2000María P. Prim MD Abstract Objectives: To assess the patency and flow of the internal jugular vein after functional neck dissection. Study Design: Prospective study of 54 internal jugular veins in 29 oncologic patients undergoing functional neck dissection between September 1994 and February 1997. Methods: Patency, presence of thrombosis, characteristics of the vein wall, compressibility, area of the vein both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were assessed in all veins before and after dissection. All patients were evaluated before and after the procedure by means of duplex Doppler ultrasonography. Results: In no case was there thrombosis before or after the operation. Although total jugular flow decreases during the early postoperative period, it recovers to normal parameters within 3 months after surgery. Conclusions: According to these results, the patency of the internal jugular vein remains unaltered after functional neck dissection. Ultrasonographically there is no thrombosis after this procedure. [source] Inside-out vein graft and inside-out artery graft in rat sciatic nerve repairMICROSURGERY, Issue 1 2003Alécio Santos Barcelos Ph.D. Although veins and arteries present similar wall structures, there are differences which may be relevant in peripheral nerve reconstruction. Inside-out vein grafts (IOVG) have been satisfactorily used to repair both motor and sensitive nerves. However, the inside-out artery graft (IOAG) is a new technique and not fully investigated. Our study presents comparative morphological data on nerve regeneration achieved with IOVG and IOAG in the repair of Wistar rat sciatic nerves. Jugular veins and aorta arteries were harvested from donor animals and used "inside-out" to bridge a 10-mm gap. Animals were sacrificed at 10 weeks to evaluate nerve regeneration. Both techniques presented great variability in nervous tissue, though some animals showed satisfactory results. Different intensities of scarring processes might have interfered with nerve regeneration. Although IOVG and IOAG techniques showed similar morphometric results, in general, IOVG presented a closer-to-normal nerve organization than IOAG. © 2003 Wiley-Liss, Inc. MICROSURGERY 23:66,71 2003 [source] Comparison of Endovenous Radiofrequency Versus 810 nm Diode Laser Occlusion of Large Veins in an Animal ModelDERMATOLOGIC SURGERY, Issue 1 2002Robert A. Weiss MDArticle first published online: 27 FEB 200 background. Endovenous occlusion using radiofrequency (RF) energy has been shown to be effective for the elimination of sapheno-femoral reflux and subsequent elimination of varicose veins. Recently, endovenous laser occlusion has been introduced with initial clinical reports indicating effective treatment for varicose veins. However, in our practice we note increased peri-operative hematoma and tenderness with the laser. Little is known regarding the mechanism of action of this new laser vein therapy. objective. To better understand the mechanism of action of endovenous laser vs. the endovenous RF procedure in the jugular vein of the goat model. methods. A bilateral comparison was performed using 810 nm diode laser transmitted by a bare-tipped optical fiber vs. the RF delivery by engineered electrodes with a temperature feedback loop using a thermocouple (Closure procedure) in three goat jugular veins. Immediate and one-week results were studied radiographically and histologically. Temperature measurements during laser treatment were performed by using an array of up to five thermocouples, spaced 2 mm apart, placed adjacent to a laser fiber tip during goat jugular vein treatment. results. Immediate findings showed that 100% of the laser-treated veins showed perforations by histologic examination and immediate contrast fluoroscopy. The RF-treated side showed immediate constriction with maintenance of contrast material within the vein lumen and no perforations. The difference in acute vein shrinkage was also dramatic as laser treatments resulted in vein shrinkage of 26%, while RF-treated veins showed a 77% acute reduction in diameter. At one week, extravasated blood that leaked into the surrounding tissue of laser treated veins acutely, continued to occupy space and impinge on surrounding structures including nerves. For the laser treatment, the highest average temperature was 729°C (peak temperature 1334°C) observed flush with the laser fiber tip, while the temperature feedback mechanism of the RF method maintains temperatures at the electrodes of 85°C. conclusion. Vein perforations, extremely high intravascular temperatures, failure to cause significant collagen shrinkage, and intact endothelium in an animal model justify a closer look at the human clinical application of the 810 nm endovenous laser technique. Extravasated blood impinging on adjacent structures may theoretically lead to increased peri-operative hematoma and tenderness. Further study and clinical investigation is warranted. [source] The workload of riding-school horses during jumpingEQUINE VETERINARY JOURNAL, Issue S36 2006M. M. SLOET Van OLDRUITENBORGH-OOSTERBAAN Summary Reasons for performing the study: As there are no reports on the real workload of horses that jump fences, this study was undertaken in riding-school horses. Objective: To compare the workload of horses jumping a course of fences with that of horses cantering over the same course at the same average speed without jumping fences. The workload variables included heart rate (HR), packed cell volume (PCV), acid-base balance (venous pH, pCO2, HCO3,) and blood lactate (LA), glucose, total protein and electrolyte concentrations. Methods: Eight healthy riding-school horses performed test A (a course of approximately 700 m with 12 jumps from 0.8-1.0 m high at an average speed of approximately 350 m/min) and test B (same course at the same speed, but without the rails) in a crossover study with at least 4 h between the 2 tests. Before each test the horses were fitted with a heart rate meter (Polar Electro)1. Blood samples were taken from the jugular vein at rest prior to the test, after warm-up before starting the course, immediately after the course and after recovery. All samples were analysed immediately. Results: The mean ± s.d maximal HR (beats/min) during the course (184 ± 17 and 156 ± 21, respectively) and the mean HR after recovery (75 ± 6 and 63 ± 7, respectively) were significantly higher in test A compared to test B (P=0.001 and P=0.007 respectively). The mean LA concentrations after the course and after recovery (mmol/1) were significantly higher in test A (3.6 ± 2.7 and 1.0 ± 0.9, respectively) compared to test B (0.9 ± 0.5 and 0.3 ± 0.1, respectively), (P=0.016 and P = 0.048 respectively). The mean PCV (1/1) after the course and after recovery was also significantly different between tests A (0.48 ± 0.04 and 0.39 ± 0.03, respectively) and B (0.42 ± 0.04 and 0.36 ± 0.03, respectively) (P<0.01). The mean pH and the mean HCO3, (mmol/1) after the course were significantly lower in test A (7.40 ± 0.04 and 28.9 ± 1.4, respectively) compared to test B (7.45 ± 0.03 and 30.4 ± 2.3, respectively) (P<0.05). Conclusions: This study indicates that in riding-school horses jumping fences, even at a low level competition, provokes a significant workload compared to cantering the same distance and speed without fences. Potential relevance: This study makes it clear that the extra workload of jumping fences should be taken into account in the training programmes of jumping horses. Further research with more experienced horses jumping higher fences will reveal the workload for top-level jumping horses. [source] Interobserver agreement in the magnetic resonance location of cerebral vein and dural sinus thrombosisEUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2007J. M. Ferro The interobserver variation in the magnetic resonance (MR) location of cerebral vein and dural sinus thrombosis (CVT) has not been previously reported. Four independent observers rated a convenience sample of 40 MR/MR angiographies to assess whether or not each dural sinus and major cerebral veins were occluded. Interobserver reliability was measured using , statistics. Interobserver agreement was comparable between the six pairs of raters. Agreement was excellent for thrombosis of the deep cerebral venous system (, = 1.00), cerebellar veins (, = 1.00), superior saggital sinus (, range: 0.82,1) and right jugular vein (, range: 0.84,0.95); good to excellent for the right transverse/sigmoid sinus (, range: 0.75,0.90) and the left jugular vein (, range: 0.65,0.85); moderate to excellent for the left lateral sinus (, range: 0.59,0.78) and the straight sinus (, range: 0.59,0.92); poor to good for the cortical veins (, range: 0.02,0.65). Agreement between observers varies with the location of CVT. It is good or excellent for most of the occluded sinus and veins, except for the cortical veins. This study suggests that information on the location of CVT can be reliably collected and used in multicentre studies. [source] Role of nitric oxide in the reflex diuresis in rabbits during pulmonary lymphatic obstructionEXPERIMENTAL PHYSIOLOGY, Issue 4 2004K. M. McCormick The role of nitric oxide in the reflex diuresis in response to pulmonary lymphatic drainage was examined in anaesthetized, artificially ventilated New Zealand White rabbits. Pulmonary lymphatic drainage was obstructed by raising the pressure in a pouch created from the right external jugular vein. Pulmonary lymphatic obstruction resulted in a significant increase in urine flow from an initial control value of 8.9 ± 0.5 ml (10 min),1 to 12.1 ± 0.6 ml (10 min),1 during lymphatic obstruction (mean ±s.e.m.; n= 17, P < 0.001). This increase in urine flow was accompanied by a significant increase in the excretion of sodium. Additionally, renal blood flow remained unchanged during the increase in urine flow caused by lymphatic obstruction. Intravenous infusion of l -NAME, a non-selective inhibitor of nitric oxide synthase (NOS), abolished the reflex diuresis. Furthermore, intraperitoneal administration of the relatively selective neuronal NOS blocker, 7-nitroindazole also abolished the response. It was observed that infusion of a more soluble neuronal NOS blocker, 7-nitroindazole sodium salt (7-NINA), into the renal medulla also abolished the reflex diuresis. These findings suggest that the increase in urine flow in rabbits caused by pulmonary lymphatic obstruction is dependent upon the integrity of neuronal NOS activity within the renal medulla. [source] Analysis of free flap viability based on recipient vein selectionHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2009David O. Francis MD Abstract Background. Venous anastomotic failure is the primary reason for microvascular free tissue transfer failure. Donor and recipient veins can be oriented in the same longitudinal axis (end-to-end anastomosis), or the donor vein can be anastomosed to the internal jugular vein in an end-to-side configuration. No consensus on the optimal anastomosis configuration exists. We sought to evaluate whether type of venous anastomosis impacts flap survival rate. Methods. Data were collected on all patients undergoing microvascular free flap reconstruction of head and neck defects at the University of Washington between August 1993 and April 2007. Flaps with a single venous anastomosis were analyzed. Flaps were stratified into those with end-to-end and end-to-side anastomoses. Survival rates were compared between groups using bivariate and multivariate techniques. Results. Inclusion criteria were met by 786 free flaps; 87% performed in an end-to-end and 13% in an end-to-side configuration. Flap re-exploration and failure rate were 4.3% and 1.1%, respectively. In multivariate analysis, there was no difference in odds of flap re-exploration (OR .70, 95% CI .23,2.18) or flap failure whether or not an end-to-end or end-to-side anastomosis was performed (OR 2.09, 95% CI .38,11.5). Conclusions. In this large cohort of patients, we found no difference in the odds of flap re-exploration or failure based on venous anastomotic configuration. Reconstructive surgeons should have both anastomotic techniques in their repertoire to optimize the success of every flap. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Ruptured internal jugular vein: A postoperative complication of modified/selected neck dissectionHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2003Suzanne S. Cleland-Zamudio MD Abstract Background. Postoperative hemorrhage from the internal jugular vein after a modified or selective neck dissection is an infrequent, yet potentially life-threatening, complication. Despite the increasing frequency of modified or selective neck dissections, this complication has not been previously highlighted in the literature. Setting. Tertiary referral academic center. Material and Methods. The records of six patients who experienced this complication were reviewed and analyzed for risk factors that might predict its occurrence. Results. Common risk factors included postoperative pharyngeal fistula formation, significant tobacco history, and poor nutritional status. A more complete circumferential dissection of the vein low in the neck in the presence of hypopharyngeal fistula may place it at a higher risk for rupture. Conclusions. Patients who have a complete circumferential dissection of the internal jugular vein low in the neck and go on to have fistulas develop may be more prone to internal jugular vein rupture. © 2003 Wiley Periodicals, Inc. Head Neck 25: 000,000, 2003 [source] Peptide-coated vascular grafts: An in vivo study in sheepHEMODIALYSIS INTERNATIONAL, Issue 4 2004Cheng Li Abstract The data on function and patency of prosthetic vascular grafts in various clinical settings are limited. The purpose of this in vivo study was to compare the function and patency of P15-coated expanded polytetrafluoroethylene (ePTFE) vascular grafts to uncoated ePTFE grafts in sheep. The P15 cell-binding peptide was covalently immobilized onto the surface of ePTFE grafts by a novel atmospheric plasma coating method. We evaluated the amount of neointimal tissue ingrowth present at the arterial and venous sides of the anastomoses and the degree of endothelial cell resurfacing of the luminal surface of the graft. Four P15-coated grafts and two control grafts were implanted as arteriovenous grafts between the femoral artery and vein and the carotid artery and jugular vein in two sheep (n = 6). One animal was euthanized after 14 days and the other after 28 days. The study showed the intimal ingrowth was significantly less. The average intimal thickness of P15-coated grafts (658 µm) was approximately two and a half times less than that of uncoated samples (1657 µm). The newly formed endothelial cell lining was thicker and its coverage was more uniform for P15-coated grafts compared to the uncoated controls. [source] Daily pattern of some fatty acids in the athletic horseJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 1 2009G. Piccione Summary In the sport field, non-esterified fatty acids (NEFA) are important for the physical performance during the aerobic exercise of short intensity and long duration. In man, rat, goat and in the sedentary horse studies on the chronometabolism showed the presence of a circadian rhythm of the plasmatic concentration of NEFA while data for the athletic horse are lacking. To define a chronogram helpful for a specific planning and the differentiation of the training programmme in the athletic horse, the circadian pattern of some fatty acids (NEFA, palmitic, stearic, oleic, linoleic and linolenic acids) was studied in five Sella Italiana horses. These horses trained following a daily model of activity consisting of walk, trot, gallop and jump of obstacles of different heights. Blood samples were collected from the jugular vein every 4 h, starting at 08:00 hours, for 2 days to assess the concentrations of total NEFA (by spectrophotometry), palmitic, stearic, oleic, linoleic and linolenic acids (by gas chromatography). anova for repeated measures showed a statistical significant effect of the time of the day in NEFA, oleic and linolenic acids. The application of the periodic model showed the periodic pattern of NEFA, oleic, linoleic and linolenic acids. Acrophases were in the afternoon for all parameters. The results obtained showed a different trend of the circadian pattern of the studied parameters in the athletic horse than in the sedentary one because the physical activity and the post-prandial metabolism acted as zeitgebers. [source] Effect of aging on corticosterone secretion in diestrous ratsJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 2 2006Ming-Jae Lo Abstract The roles of age and prolactin (PRL) in regulating glucocorticoid secretion in diestrous rats were investigated. Adrenal zona fasciculata-reticularis (ZFR) cells from young, adult, middle (mid)-aged, and old female rats were isolated. Estrous cycle stage was determined by light microscopy after vaginal smears. Blood samples were collected from right jugular vein at 0, 30, 60, and 120 min after challenge with adrenocorticotropin (ACTH). During the diestrous phase, plasma levels of estradiol and progesterone were lower in mid-aged and old rats than in either young or adult rats. Age-dependent increases of the basal levels of plasma PRL and corticosterone were observed. No difference of ACTH-increased plasma concentrations of corticosterone was observed among young, adult, mid-aged, and old rats. Aging increased the basal, ACTH-, PRL-, forskolin (an adenylate cyclase activator)-, and 3-isobutyl-l-methylxanthine (IBMX, a non-selective phosphodiesterase inhibitor)-stimulated release of corticosterone and production of adenosine 3,, 5,-cyclic monophosphate (cAMP) in ZFR cells. However, the 8-Br-cAMP (a membrane-permeable cAMP)-stimulated release of corticosterone was not affected by age. Taken together, these data indicated that aging increased corticosterone secretion in female rats during diestrous phase, which is in part due to an increase in cAMP accumulation. In conclusion, aging and PRL play a stimulatory role in the co-regulation of corticosterone secretion. J. Cell. Biochem. © 2005 Wiley-Liss, Inc. [source] Central venous access for haemodialysis: prospective evaluation of possible complicationsJOURNAL OF CLINICAL NURSING, Issue 2 2007Denise De Andrade PhD Aims and objectives., The combination of chronic renal insufficiency and haemodialysis represents a challenge for health professionals. Chronic renal insufficiency patients undergoing haemodialysis treatment through a temporary double-lumen catheter were prospectively studied in order to identify the type and frequency of local and systemic complications. Methods., A six-month period was established with a view to the inclusion of new cases. Data were acquired through interviews, clinical assessment and patient records, and entered into a Microsoft Excel database through a double entry system and exported to the Statistical Package Social Sciences software. Sixty-four patients were evaluated prospectively, of which thirty-eight (59.4%) were men and 35 (54.7%) required catheter insertion for immediate treatment. During the study period, 145 catheters were inserted, ranging from 1 to 7 implants per patient, 29 (45.3%) were single insertions and 127 (87.6%) catheters were inserted into the jugular vein. The catheters were left in place for an average of 30 days. Results., Forty-one (64%) presented inadequate functioning, after about 26 days. A febrile state occurred in 24 (37.5%) patients after 34 days, secretion at the catheter entry site in 27 (42.2% after 26 days and bloodstream infection was encountered in 34(53%) after 34 days. Of the 61 blood culture samples, thirty (49%) were positive for Staphylococcus aureus that was the microorganism most frequently isolated. Conclusion., The findings indicate worrying aspects such as the catheters permanence time, exposing patients to different complications, including infection. Furthermore, inadequate catheter functioning leads to inefficient haemodialysis treatment. Relevance to clinical practice., Knowledge about complications allows for systematic care planning, prevention and control actions. [source] Early Results of Balloon Dilatation of the Stenotic Bovine Jugular Vein Graft in the Right Ventricular Outflow Tract in ChildrenJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2008J. STEINBERG M.D. The aim of this study was to evaluate the early results of interventional balloon dilatation of stenotic bovine jugular vein (BJV) grafts implanted for reconstruction of the right ventricular outflow tract (RVOT) in children. Methods: From May 2001 to December 2005, 153 BJV grafts were implanted in children in our institution. An average of 16.9 (7.6,41.1) months after implantation, 17 balloon dilatations in a significant stenosis proximal (n = 1), distal anastomosis (n = 8), BJV valve (n = 3), or at multiple sites (n = 5) were performed in 15 children (male:female = 9:6) with a mean age of 3.9 (0.8,13.0) years. Balloon diameter was 75,133.3% (mean 100.3) of the original BJV size. Mean follow-up was 8.8 (2 days to 22.8 months) months. Results: In 10 interventions (58.8%) the instantaneous peak gradient was reduced below 50 mmHg. A balloon diameter ,100% of the original BJV size correlated significantly with a successful intervention. No major complications, two minor (nonobstructive floating membranes at the dilatation site and one septicemia) occurred afterward. Freedom from reintervention after 6 months was 58.2% for all, 77.8% for dilatations of the proximal anastomosis and mixed stenotic lesions, and 33.3% for the distal anastomosis. Conclusion: Balloon dilatation of stenotic BJV grafts is safe and can significantly reduce the pressure gradient in two-thirds of interventions. Balloon diameters above the original graft size should be aimed for. The most frequent stenosis of the distal anastomosis tends to renarrow early after dilatation. Nevertheless, balloon dilatation should be considered in nearly every stenotic graft to gain time until a surgical or interventional graft exchange. [source] Importance of Jugular Valve Incompetence in Contrast Transcranial Doppler Ultrasonography for the Diagnosis of Patent Foramen OvaleJOURNAL OF NEUROIMAGING, Issue 3 2003M. Akif Topçuoglu MD ABSTRACT Transcranial Doppler (TCD) ultrasound with the intravenous injection of agitated saline as contrast (cTCD) is an effective method for detecting right-to-left intracardiac and extracardiac shunt (RLS); however, the sensitivity of cTCD in the diagnosis of RLS remains slightly less than that of transesophageal echocardiography, even in patients with adequate transtemporal ultrasonic bone windows. The authors present a case with cTCD underestimating RLS because of jugular valve incompetence in a 42-year-old man presenting with an episode of transient aphasia. Three weeks after transcatheter closure of a patent foramen ovale associated with an atrial septal aneurysm, he experienced 2 episodes of amaurosis fugax. Following a negative 45-minute embolus detection study with power M-mode TCD, the patient underwent a cTCD study with monitoring of the left middle cerebral artery (MCA), the anterior cerebral artery, and the submandibular extracranial internal carotid artery. A single microbubble (MB) was detected in the left MCA in only 1 of 5 studies; the remaining runs all failed to detect an RLS. Significant MB reflux was noted in the left internal jugular vein because of jugular valve incompetence. The authors conclude that incompetence of the jugular vein valve can result in a false negative cTCD study for RLS detection. [source] Bioavailability and pharmacokinetic model for ritonavir in the ratJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 3 2007R. Lledó-García Abstract The aim of this study is to investigate in vivo the oral bioavailability of ritonavir and to evaluate the pharmacokinetic model that best describes the plasma concentration behavior after oral and intravenous administration. Male Wistar rats were intravenously administered at 3 mg dose of pure ritonavir and oral administered at 4.6,±,2.5 mg of diluted Norvir®. Blood samples were taken by means of the jugular vein for a 24 h period of time. An analytical high-performance liquid chromatography (HPLC) technique was developed in order to quantify ritonavir plasma concentrations. A nonlinear modeling approach was used to estimate the pharmacokinetic parameters of interest. Results showed that a two-compartmental model with zero-order kinetic in the incorporation process of ritonavir into the body better fitted intravenous and oral data. The estimated oral bioavailability by means of noncompartmental and compartmental approaches resulted in 74% and 76.4%, respectively. These values confirm the ones obtained by other authors in the rat. In conclusion, a zero-order kinetic in the incorporation process at the administered doses suggests the saturation of the possible specialized transport mechanisms involved in the incorporation of ritonavir into the body. These results could justify the use of low doses of ritonavir when improving the bioavailability of other protease inhibitors (PIs) is required. © 2006 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci [source] Assessing the antifungal activity and toxicity profile of amphotericin B lipid complex (ABLC; Abelcet®) in combination with caspofungin in experimental systemic aspergillosisJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 6 2004Olena Sivak Abstract The purpose of this study was to assess the antifungal activity and renal and hepatic toxicity of amphotericin B lipid complex (ABLC; Abelcet®) following co-administration of Caspofungin to rats infected with Aspergillus fumigatus. Aspergillus fumigatus inoculum (1.3,2.3,×,107 colony forming units [CFU]) was injected via the jugular vein; 48 h later male albino Sprague,Dawley rats (350,400 g) were administered either a single intravenous (IV) dose of Fungizone® (1 mg AmpB/kg), ABLC (1 or 5 mg AmpB/kg), or an equivalent volume of normal saline (NS) (vehicle control) once daily for 4 days. Rats were further randomized into groups to receive 3 mg/kg Caspofungin or physiologic saline IV once daily for 4 days. To assess antifungal activity, brain, lung, heart, liver, spleen, and kidney sections were homogenized with NS (2 mL; 1 g of each tissue/mL) and a 0.1-mL aliquot was spread plated onto a Sabouraud dextrose agar plate. The plates were incubated for 48 h at 37°C, at which time the numbers of CFU were determined and corrected for tissue weight. To assess renal and hepatic toxicity, serum creatinine and aspartate aminotransferase levels were determined. Fungizone and ABLC at a dosing regimen of 1 mg/kg i.v. once daily for four consecutive days and Caspofungin at a dosing regimen of 3 mg/kg i.v. once daily for four consecutive days had similar effectiveness in decreasing the total number of Aspergillus fumigatus CFUs found in all organs analyzed compared to non-treated controls. A combination of ABLC (1 mg/kg i.v.,×,4 days) and Caspofungin (3 mg/kg i.v.,×,4 days) significantly decreased the total number of Aspergillus fumigatus CFUs found in all organs analyzed compared to Caspofungin alone and non-treated controls. ABLC at a dosing regiment of 5 mg/kg i.v. once daily for four consecutive days was more effective in decreasing the total number of Aspergillus fumigatus CFUs found in all organs analyzed compared to Fungizone or ABLC alone at 1 mg/kg and Caspofungin alone at 3 mg/kg. However, a combination of ABLC (5 mg/kg i.v.,×,4 days) and Caspofungin (3 mg/kg i.v.,×,4 days) was not more effective than ABLC at 5 mg/kg or the combination of ABLC at 1 mg/kg and Caspofungin 3 mg/kg in reducing the total number of Aspergillus fumigatus CFUs compared to controls. Except for non-treated infected control rats, none of the treatment groups tested displayed a greater than 50% increase in serum creatinine concentrations from baseline. In addition, only ABLC at a dosing regimen of 1 mg/kg i.v. once daily for four consecutive days displayed a greater than 50% increase in AST concentration from baseline. Taken together, these findings suggest that ABLC at 5 mg/kg once daily,×,4 days appears to be the best therapeutic choice in this animal model. © 2004 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 93:1382,1389, 2004 [source] An outcome study on complications using routine ultrasound assistance for internal jugular vein cannulationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2007M. Lamperti Background:, Ultrasound guidance for central venous cannulation is advised by recent guidelines, but is not being applied in everyday practice. The purpose of this study was to determine the reduction in complications when applying an ultrasound locating device for internal jugular vein catheterization. Methods:, An observational study was conducted from November 2004 to October 2005 in a tertiary neurosurgical hospital on 300 patients undergoing internal jugular vein cannulation using an ultrasound technique. Patients were not randomized and operators were trained using theoretical and practical courses. Prior to the study, the investigators, who were consultant anaesthesiologists, had to perform at least 20 successful supervised cannulations. Results:, Cannulation was successful in all cases. The incidence of arterial puncture was 2.7%, and multiple venous punctures represented the main minor complication (14%). Bivariate analysis of the overall complications revealed no significant correlation with age group, American Society of Anesthesiologists' (ASA) classification, body mass index, or position and diameter of the vein. Conclusions:, Ultrasound cannulation of the internal jugular vein minimized complications. These could be avoided when new ultrasound probes and specific needles are introduced. [source] External jugular venous catheterization with a Groshong catheter for central venous access,JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2008Mitsuru Ishizuka MD Abstract Background The Groshong catheter (GC) is commonly used as a peripherally inserted central catheter (PICC), and the external jugular vein (EJV) is not a common route for central venous access (CVA). Therefore, external jugular venous catheterization (EJVC) using a GC is rare. However, our experience has shown that this procedure is safe and simple for CVA. Purpose To assess the utility of EJVC using the GC for CVA. Methods CVA was done using a GC via the EJV with a single puncture employing the maximal barrier precaution technique. Results Between March 2005 and June 2007, we attempted to perform EJVC using a GC via the EJV for 331 patients. Among of these patients, 301 patients received successful catheterization (success rate: 301/331,=,90.9%). The total period of catheter insertion was 4601 days, and the mean insertion period was 15.1 days (range 2,147 days). The main complications of catheter insertion were malposition (8/301; 2.7%) and, oozing or hematoma formation (8/301; 2.7%). There were no severe complications such as nerve injury, pneumothorax or arterial bleeding. Conclusions Our experience demonstrates that EJVC using the GC is acceptable for CVA. J. Surg. Oncol. 2008;98:67,69. © 2008 Wiley-Liss, Inc. [source] ,2 -Antiplasmin plays a significant role in acute pulmonary embolismJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 8 2003H. Matsuno Summary., The importance of pulmonary embolism (PE) due to venous thrombosis is recognized in the treatment of vascular diseases. We have investigated the physiological effects of plasmin generation in experimental acute PE using mice deficient in plasminogen (Plg,/,) or ,2 -antiplasmin (,2 -AP,/,). PE was induced by continuous induction of venous thrombus in the left jugular vein by endothelial injury due to photochemical reaction. The mortality of wild-type mice was 68.8% at 2 h after the initiation of venous thrombosis and it was significantly reduced in ,2 -AP,/, mice (41.7%). In contrast, Plg,/, mice did not survive. Histological evidence of thromboembolism in the lung was obtained in all mice. However, whereas a strict thromboembolism was observed in Plg,/, mice, only a few thrombi were detected in the lungs of ,2 -AP,/, mice. Plasma fibrinogen levels measured in mice were not different. When ,2 -AP was infused in ,2 -AP,/, mice, the mortality was indistinguishable from wild-type mice. Tissue-type plasminogen activator (tPA) did not reduce the mortality due to acute PE in wild-type mice. However, in ,2 -AP,/, mice, tPA (0.52 mg kg,1) significantly decreased the mortality compared with that of ,2 -AP,/, mice without tPA. The bleeding time was not significantly prolonged in either type of mice treated with tPA. The lack of plasminogen increases the mortality due to acute PE while a lack of ,2 -AP decreases the mortality rate, which can be further reduced by tPA administration. Therefore, the combination of inhibition of ,2 -AP with thrombolytic therapy could be beneficial in the treatment of acute PE. [source] Effects of Time of Collection and Sample Processing on von Willebrand Factor Concentration in Retired Racing GreyhoundsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2008L.M. Marín Background: Concentrations of von Willebrand factor (vWF) are less than 30% in approximately 10% of Greyhounds. Hypothesis: That sample collection, processing, and storage can affect the concentration of vWF in plasma of Greyhounds. Animals: Nineteen healthy former racing Greyhounds. Methods: Prospective study: Blood samples were obtained from the jugular vein of dogs at 4 times during the day. Samples were divided and processed in each of 3 ways. The 1st tube was centrifuged immediately, the 2nd tube was kept in a household refrigerator, and the 3rd tube was kept at room temperature for 3 hours before centrifugation and processing. Results: There were no significant differences in the vWF concentration between different sample storage and processing (P=5.31). There was no statistically significant diurnal variation in vWF concentration in the samples evaluated (P=.37). Conclusions and Clinical Importance: Time of sample collection and short-term storage temperature do not influence the vWF concentration in retired racing Greyhounds. [source] Cardiac Output Technologies with Special Reference to the HorseJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2003Kevin T.T. Corley Critical illness, anesthesia, primary cardiovascular disease, and exercise may result in marked hemodynamic alterations. Measuring cardiac output (CO) is central to defining these alterations for both clinician and researcher. In the past 10 years, several new methods of measuring CO have been developed for the human medical market. Some of these methods are now validated in the horse and are in clinical use. The Fick method has been used in equine research for more than a century. It depends on simultaneous measurement of mixed venous (pulmonary arterial) and peripheral arterial oxygen content and oxygen uptake by the lungs. The technique is technically demanding, which restricts its clinical use. Indicator dilution techniques, with indocyanine green, cold (thermodilution), or lithium as the marker, have also been widely used in the horse. The indocyanine technique is cumbersome, and thermodilution requires right heart catheterization, which is not a benign procedure, making both of these methods less than ideal for clinical use. Lithium dilution requires catheterization of a peripheral artery and a jugular vein. It has recently been validated in anesthetized adult horses and neonatal foals. Doppler echocardiography is a noninvasive ultrasound-based technique. More accurate measurements are obtained with transesophageal than with transthoracic measurements; however, both methods require considerable technical expertise. Bioimpedance and pulse contour analysis are 2 new methods that have yet to be validated in the horse. With the currently available technology, lithium dilution appears to be the method of measuring CO best suited to the equine clinic. [source] Placental transfer and pharmacokinetics of allopurinol in late pregnant sows and their fetusesJOURNAL OF VETERINARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2008A. J. VAN DIJK Xanthine oxidoreductase (XOR) is a key enzyme in the evolvement of reperfusion injury resulting from birth asphyxia, a common cause of decreased viability and perinatal mortality in newborn piglets under farm conditions. At present no standard pharmacological intervention strategy is available to reduce these adverse effects of birth asphyxia. In the present study we aimed to evaluate placental transfer of allopurinol, an inhibitor of XOR. For this purpose, fetal catheterization of the jugular vein was conducted in five late pregnant sows (one fetus per sow). At 24,48 h after surgery, sows received allopurinol (15 mg/kg body weight; i.v.) and pharmacokinetics of allopurinol and its active metabolite oxypurinol were measured in both late pregnant sows and fetuses. Maternal and fetal blood samples were collected during and after allopurinol administration. Maternal Cmax values averaged 41.90 ,g/mL (allopurinol) and 3.68 ,g/mL (oxypurinol). Allopurinol crossed the placental barrier as shown by the average fetal Cmax values of 5.05 ,g/mL at 1.47 h after allopurinol administration to the sow. In only one fetus low plasma oxypurinol concentrations were found. Incubations of subcellular hepatic fractions of sows and 24-h-old piglets confirmed that allopurinol could be metabolized into oxypurinol. In conclusion, we demonstrated that allopurinol can cross the placental barrier, a prerequisite for further studies evaluating the use of allopurinol as a neuroprotective agent to reduce the adverse effects following birth asphyxia in neonatal piglets. [source] MR susceptometry for measuring global brain oxygen extractionMAGNETIC RESONANCE IN MEDICINE, Issue 5 2006María A. Fernández-Seara Abstract Monitoring of oxygen saturation in jugular venous blood gives an estimate of the balance of global oxygen delivery and cerebral oxygen consumption. We present a noninvasive approach to measure oxygen saturation in vivo in the internal jugular vein using MR susceptometry by exploiting the characteristic susceptibility of deoxyhemoglobin, and demonstrate the feasibility of performing such measurements in a group of subjects. We assessed the sensitivity of the method for detecting small changes in oxygen saturation by monitoring the variations observed during breath-holding and hypoventilation experiments. Unlike alternative methods, the susceptometric technique does not require calibration. Magn Reson Med, 2006. © 2006 Wiley-Liss, Inc. [source] The Effect of Rigid Cervical Collars on Internal Jugular Vein DimensionsACADEMIC EMERGENCY MEDICINE, Issue 1 2010Michael B. Stone MD Abstract Objectives:, Prior research has demonstrated that rigid cervical collars cause an increase in intracranial pressure (ICP). The mechanism for this effect is unclear and one proposed mechanism involves obstruction of venous outflow in the neck. Ultrasound (US) allows assessment of internal jugular vein dimensions and may yield information regarding the mechanism for the increase in ICP seen with rigid collar application. Methods:, Forty-two healthy volunteers underwent US examination of the internal jugular vein before and after cervical collar application. Internal jugular vein cross-sectional areas were compared with and without the cervical collar in place. Results:, The cross-sectional area of the internal jugular vein increased significantly (p < 0.0001) after application of the cervical collar. The mean percentage increase in cross-sectional area was 37% (95% confidence interval [CI] = 20% to 53%). Conclusions:, Internal jugular vein cross-sectional area increases after application of a rigid cervical collar. This supports the hypothesis that venous obstruction in the neck may contribute to the increase in ICP seen after rigid collar application. ACADEMIC EMERGENCY MEDICINE 2010; 17:100,102 © 2009 by the Society for Academic Emergency Medicine [source] Cephalad origin of the superior vena cava and the level of the central venous catheter tip on chest radiographsPEDIATRIC ANESTHESIA, Issue 1 2005TOSHIMI ARAI MD Summary Background :,There are suggested radiographic landmarks for the lower margin of the superior vena cava (SVC), but none for the cephalad origin of the SVC in children. Therefore, we determined the cephalad origin of the SVC in relation to the level of thoracic vertebrae in children. Methods :,Sixty-five patients (2,96 months) scheduled for routine diagnostic cardiac catheterization were the subjects of the study. Vena cavogram was obtained. The crossing point between the SVC and the innominate vein was considered as the cephalad origin of the SVC, then this point was related to the level of the thoracic vertebra as a radiographic landmark. Results :,In approximately 90% of the patients studied the proximal origin of the SVC was situated above the level of Th4/5 interspace. Conclusion :,We would like to suggest that the position of the tip of central venous line, when inserted via the right internal jugular vein, should optimally be at the level of Th4/5 interspace on the postoperative chest radiograph. [source] Outcome of pulmonary function in Lemierre's disease-associated acute respiratory distress syndrome,PEDIATRIC PULMONOLOGY, Issue 4 2007Jill M. Cholette MD Abstract Pulmonary function in acute respiratory distress syndrome (ARDS) survivors typically returns to normal with the exception of a persistent reduction in carbon monoxide diffusion capacity (DLco). Septic thrombophlebitis of the internal jugular vein, (Lemierre's syndrome or postanginal sepsis) is a well-described, albeit uncommon cause of ARDS in which metastatic pulmonary thromboemboli precipitate respiratory failure requiring ventilatory support. We describe convalescent pulmonary function in two survivors of Lemierre's disease-associated ARDS, suggesting that the subset of Lemierre's syndrome induced ARDS survivors have an excellent long-term pulmonary prognosis. Pediatr Pulmonol. 2007; 42:389,392. © 2007 Wiley-Liss, Inc. [source] Effects of Exogenous Tumour Necrosis Factor-, on the Secretory Function of the Bovine Reproductive Tract Depend on Tumour Necrosis Factor-, ConcentrationsREPRODUCTION IN DOMESTIC ANIMALS, Issue 3 2009DJ Skarzynski Contents The aim of study was to correlate tumour necrosis factor-, (TNF) infused doses used with the TNF concentrations achieved and with the secretory function of both the ovary and the uterus in cows. We evaluated the concentrations of progesterone (P4), prostaglandin (PG)F2,, PGE2 nitric oxide (NO) and TNF in the jugular vein and vena cava caudalis as parameters of exogenous TNF action on the female reproductive tract. Aortae abdominalis of cows (n = 18) were infused with saline or two doses of TNF (luteolytic , 1 ,g or luteotrophic , 10 ,g). In the peripheral blood, 1 ,g TNF concentrations achieved within the range of 30,45 pg/ml, and 10 ,g TNF provoked a sharp increase in achieved concentrations at a range of 250,450 pg/mL). The TNF concentrations achieved in vena cava caudalis were five to six times higher than that in peripheral blood (p < 0.001). One microgram TNF increased PGF2, and NO (p < 0.001) and decreased P4 (p < 0.05). The higher TNF dose stimulated P4 and PGE2 (p < 0.01). TNF infusion at luteolytic dose achieved its concentrations at the physiological range previously observed in cows. Luteotrophic TNF dose achieved the concentrations in vena cava caudalis that are much higher than physiological level and were previously noted in pathological circumstances (i.e. mastitis, metritis). [source] Chondrosarcomas of the Jugular ForamenTHE LARYNGOSCOPE, Issue 10 2008Mario Sanna MD Abstract Objectives/Hypothesis: Chondrosarcomas of the jugular foramen are extremely rare tumors. Our review of the literature revealed eleven previously reported cases. The aim of this study is to describe the presenting symptoms, radiographic findings, operative procedures, and postoperative outcome of five histologically confirmed cases of chondrosarcomas arising from the jugular foramen. A review of the literature is also presented. Study Design: Retrospective study of an quaternary referral otology and skull base private center. Methods: Five cases of surgically treated and pathologically confirmed jugular foramen chondrosarcomas were identified. The follow-up of the series ranged from 23 to 42 months (mean, 32.8 ± 7.7 months). Results: A single stage procedure was adopted in all the cases. Two patients underwent type A infratemporal approaches, one patient underwent a transotic approach extending to the neck with ligature of the internal jugular vein, one patient underwent a petro-occipital transigmoid approach, and one patient underwent a combined petro-occipital transigmoid,transotic approach. Gross total tumor removal was achieved in all patients. The most common complications were lower cranial nerve deficits. To date, no recurrence or residual tumors have been observed at radiological controls. Conclusions: We believe that the primary treatment for chondrosarcomas of the jugular foramen is gross total surgical resection of the tumor. It is our philosophy to reserve postoperative radiotherapy for patients with histologically aggressive tumors, as well as in cases with subtotal resection and recurrent tumors. [source] Minimally Invasive Thyroidectomy: Basic and Advanced TechniquesTHE LARYNGOSCOPE, Issue 3 2006David J. Terris MD Abstract Objective: Minimal access surgery in the thyroid compartment has evolved considerably over the past 10 years and now takes many forms. We advocate at least two distinct approaches, depending on the disease process and multiple patient factors. The technical aspects are explored in depth with liberal use of videographic demonstration. Methods: The authors conducted a comparison of two distinct surgical techniques with photographic and videographic documentation of two distinct minimal access approaches to the thyroid compartment termed minimally invasive thyroidectomy (MITh) and minimally invasive video-assisted thyroidectomy (MIVAT). Both historic and previously unpublished data (age, gender, pathology, incision length, and complications) are systematically analyzed. Results: Patients who underwent minimally invasive thyroidectomy (n = 31) had a mean age of 39.4 ± 10.7 years; seven were male and 24 were female. The most common diagnosis was follicular or Hürthle cell adenoma (29%), followed by papillary or follicular cancer (26%). The mean incision length was 4.9 ± 1.0 cm. One patient developed a hypertrophic scar and one patient developed thrombophlebitis of the anterior jugular vein. There were 14 patients in the MIVAT group with a mean age of 43.7 ± 11.4 years; one was male and 13 were female. The majority of patients had follicular adenoma (42.9%) or papillary carcinoma (21.4%) as their primary diagnosis. The mean incision length was 25 ± 4.3 mm (range, 20,30 mm), and there were no complications. Conclusions: Two distinct approaches to minimal access thyroid surgery are now available. The choice of approach depends on a number of patient and disease factors. Careful patient selection will result in continued safe and satisfactory performance of minimally invasive thyroid surgery. [source] | |||||||||||||||||||||||||||||||||||||