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Proximal Segment (proximal + segment)
Selected AbstractsHemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral re,uxINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2005TETSUYA FUJIMURA Abstract A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral re,ux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral re,ux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection. [source] Two new species of DiaphanosomaFischer, 1850(Crustacea: Branchiopoda: Cladocera) from the United StatesINTERNATIONAL REVIEW OF HYDROBIOLOGY, Issue 2 2005Nikolai M. Korovchinsky Abstract Two new species of the genus Diaphanosoma,D. oligosetum and D. dorotheae, from Louisiana and North Carolina respectively, are described. The former species has large head with protruding dorsal part, large lanceolate spine on the basipodite's distal outer end, an extremely reduced number of antennal setae, up to six in adult specimens, and unique armament of valve margin. On the whole, it shows the pronounced combination of primitive and specialized morphological traits. D. dorotheae is a member of D. brachyurum species group differing from its other known representatives in presence of a small but very conspicuous spine on the end of proximal segment of antennal exopodite and a variable number of setae (seven or eight) on the distal segment of the branch. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Separation between the digestive and the respiratory lumina during the human embryonic period: morphometric study along the tracheo-oesophageal septumJOURNAL OF ANATOMY, Issue 1 2001JOSEP NEBOT-CEGARRA An isolated tracheo-oesophageal fistula could be caused by close proximity of the epithelia of both organs (O'Rahilly & Müller, 1984; Kluth et al. 1987) at certain embryonic stages, the most frequent location being the tracheal bifurcation. Thus the relative position and degree of separation between the digestive and the respiratory tubes throughout their development may be relevant to the origin of this anomaly. The aim of this study was to analyse along the different segments of the tracheo-oesophageal septum (TES) where the closest relationship between both lumina occurred and what degree of separation was present at each segment. Computer imaging techniques were applied on cross sections of a graded series of normal human embryos (Carnegie stages (CS) 13,23). In addition, the differentiation of the primitive TES was also studied (from CS 12) by light microscopy. Between CS 13 and 16 both tubes tended to separate (phase of separation), principally at the proximal segments of the laryngopharyngeal and the tracheo-oesophageal portions of the TES. During this phase the separation between the trachea and oesophagus was wider than between the larynx and pharynx. From CS 17 to CS 23 the digestive and respiratory lumina reached their widest separation at different levels of the laryngopharyngeal portion. Below these levels they tended to come closer together, principally at the proximal segment of the tracheo-oesophageal portion, but also at the distal part of the laryngopharyngeal portion. During this phase of approximation they reached their closest relationship at the proximal (CS 17) and the distal (from CS 18) segments of the tracheo-oesophageal portion. When finally the distal segment of the trachea (which includes the bifurcation) comes closest to the oesophagus, the coats of both organs have already undergone an appreciable differentiation. According to these observations, the origin of the most frequent isolated tracheo-oesophageal fistula at the bifurcation region could not be explained from the normal development of the TES. [source] Mapping of intrinsic bent DNA sites in the upstream region of DNA puff BhC4-1 amplified geneJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 1 2001Adriana Fiorini Abstract We have identified bent DNA sites in the distal and proximal DNA puff BhC4-1 amplified gene promoter region of Bradysia hygida. The 2D modeling of the 3D DNA path and the ENDS ratio values calculated in this promoter region resulted in the identification of ten pronounced bent sites named BhC4B ,,9 to +,1. The 1847 bp fragment (,,3697 to ,,1850) in relation to the transcription start site shows multiple bending sites, BhC4B ,,9 to BhC4B ,,4, with periodicity ,300 bp. The analysis of the other identified bent region, starting at position ,,957, reveals that the BhC4B +,1 bent site colocalizes with the putative BhC4-1 minimal promoter. The sequence analysis of bent site BhC4B ,,4 shows a distribution of dA,dT at ,10 bp intervals between the middle of each tract, but intervals with more than one turn, ,20 bp, two helix turns, were detected in the other bent sites described here. The bent sites BhC4B ,,6 and BhC4B ,,4, contain two consensus sequences, with 60 bp each. The apparent molecular weight of fragments in the BhC4-1 promoter region were estimated in agarose gels and compared with the data obtained in polyacrylamide gels without and with ethidium bromide. The mobility reduction ratios (R -values) were determined, and a high R -value, 1.80, for a 1215 bp fragment in the distal promoter region and a 1.23 significant R -value for a 662 bp fragment in the proximal segment were found. To further analyze the predicted bent DNA sites in these fragments, the 2D trajectories of the 3D DNA path and other parameters, AT percentage, roll angle, ENDS ratio and ,G, were determined. The role of these bent sites in the BhC4-1 transcription regulation is discussed. © 2001 Wiley-Liss, Inc. [source] Profile of P-glycoprotein distribution in the rat and its possible influence on the salbutamol intestinal absorption processJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 6 2004Belén Valenzuela Abstract The intrinsic absorption of salbutamol in different intestinal segments of the rat was measured and related with the corresponding intestinal P-glycoprotein (P-gp) expression levels. The apparent absorption rate constants (ka, h,1) observed in each fraction by means of the "in situ" rat gut absorption method after perfusion of a 0.29-mM isotonic solution of salbutamol were used as absorption indexes. In a separate series of studies, a semiquantitative analysis of the mRNA expression of P-gp by means of polymerase chain reaction and Western blot with an antibody raised against the P-gp were also performed. The "in situ" ka values determined in the different segments (h,1) showed that the absorption is not homogeneous along the intestinal tract, that is, 0.499,±,0.054 for colon, 0.474,±,0.052 for the proximal segment, 0.345,±,0.014 for the mean, and 0.330,±,0.023 for the distal fraction. Addition of verapamil to the perfusion fluid did provide a better absorption of salbutamol in the distal segment. The analysis of the mRNA expression and levels of P-gp showed that the enzyme content in each section of the intestine was inversely related to salbutamol absorption. © 2004 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 93:1641,1648, 2004 [source] ELECTROPHYSIOLOGICAL ABNORMALITIES IN DIABETIC PATIENTSJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2000B. Lanzillo We studied 476 patients affected by diabetes: 166 male (mean age 61.6 ± 10 years, range 27,91) and 310 female (mean age 61.5 ± 8.4 years, range 25,82). Mean disease duration was 11.3 ± 7.6 years, range 0.3,37). All patients underwent surface motor and sensory nerve conduction along median, popliteal, and sural nerve. Results. Median nerve: in 3.1% of subjects sensory action potentials (SAP) was absent; sensory nerve conduction velocity (SNCV) was reduced in 41.8% in distal segment and in 27.5% in the proximal segment. Motor nerve conduction (MNCV) was reduced in 29.9% of the subjects. Sural nerve: SAP was absent in 24.4% and SNCV was reduced in 32.7%. Popliteal nerve: MNCV was abnormal in 30.4% of the subjects. Combining electrophysiological data we observed that: 1. 28.6% of the subjects resulted normal 2. 12.8% were affected by a lower limbs sensory neuropathy 3. 0.2% had a lower limbs motor neuropathy 4. 5.9% had a lower limbs sensory-motor neuropathy 5. 6.1% had a diffused sensory neuropathy 6. 30.2% had a diffused sensory-motor neuropathy 7. 16.2% had a carpal tunnel syndrome. Patients were divided in 2 groups: patients with and patients without neuropahy: the latter showed a significantly shorter disease duration (12.7 ± 8.1 vs 9.0 ± 6.3; p < 0.0001). In addition, we observed a significant correlation between disease duration and distal latency, median and popliteal MNCV, and SNCV in median and sural nerve (Regression test; p < 0.0001). Patients on insulin showed a longer disease duration and more severe electrophysiological abnormalities. [source] Left Atrial Catheter Ablation Promotes Vasoconstriction of the Right Coronary ArteryPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 2007EIJI YAMASHITA M.D. Background: Multiple cardiac ganglia are present in the left atrial (LA) region, and marked changes in autonomic nervous activity can occur after left atrial catheter ablation (CA) for atrial fibrillation (AF). Vasospastic angina involving the inferior wall of the left ventricle has been reported as a complication shortly after LACA. Methods: We studied 20 patients with drug-refractory AF who underwent LACA, performed to encircle the left- and right-sided pulmonary veins, 1 to 2 cm from their ostia under fluoroscopic guidance. Quantitative coronary angiography was performed before and after LACA, and we analyzed the minimal lesion diameter (MLD) of the proximal segment of the coronary arteries, and the basal tone, the baseline percent constriction versus maximal dilation after nitroglycerin administration. Results: No significant difference was observed in MLD or basal tone of the left coronary arteries after LACA. However, in the right coronary artery (RCA), the basal MLD was smaller (P < 0.01) and the basal tone was greater (P< 0.05) after than before LACA. No correlation was found between the baseline MLD or tone of the RCA and total amount of radiofrequency energy delivered or procedure duration. In 75% of RCA, the baseline MLD was smaller after than before LACA, which was significantly higher (P < 0.01) than observed in the left coronary arteries (38%). Conclusion: Vasoconstriction was promoted in the RCA shortly after LACA, which may explain the variant angina reported after LACA. [source] Structural Differences in the Umbilical Vein Wall after Full-Term and Pre-term DeliveryANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 5 2009M. Bagyánszki Summary With the exception of its most proximal segment, the human umbilical cord lacks innervation. It might be expected, therefore, that a paracrine effect through the direct contact between the smooth muscle cells and the endothelium may be particularly important in the control of the fetoplacental circulation. In this study, electron microscopy and immunohistochemistry were applied to examine umbilical veins immediately after full-term and pre-term delivery. The smooth muscle cells in the upper layer of the tunica media exhibited long, foot-like processes with c-kit immunoreactivity. In the umbilical vein of full-term neonates more than 50% of these cell processes display a normal ultrastructure and they were closely associated with the lamina elastica interna. Whereas in pre-term infants more than 60% of these cell processes exhibit signs of severe shrinkage and detachedness from the lamina elastica interna. At the same time, the high level of immunoreactivity of the endothelial cells as regards the proapoptotic gene product Bax in pre-term infants is indicative of an enhanced apoptotic process in these cells. [source] Utility of Lead aVR for Identifying the Culprit Lesion in Acute Myocardial InfarctionANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2009B.Sc., Jřrgen Tobias Kühl M.A. Background: Lead aVR is a neglected, however, potentially useful tool in electrocardiography. Our aim was to evaluate its value in clinical practice, by reviewing existing literature regarding its utility for identifying the culprit lesion in acute myocardial infarction (AMI). Methods: Based on a systematic search strategy, 16 studies were assessed with the intent to pool data; diagnostic test rates were calculated as key results. Results: Five studies investigated if ST-segment elevation (STE) in aVR is valuable for the diagnosis of left main stem stenosis (LMS) in non,ST-segment AMI (NSTEMI). The studies were too heterogeneous to pool, but the individual studies all showed that STE in aVR has a high negative predictive value (NPV) for LMS. Six studies evaluated if STE in aVR is valuable for distinguishing proximal from distal lesions in the left anterior descending artery (LAD) in anterior ST-segment elevation AMI (STEMI). Pooled data showed a sensitivity of 47%, a specificity of 96%, a positive predicative value (PPV) of 91% and a NPV of 69%. Five studies examined if ST-segment depression (STD) in lead aVR is valuable for discerning lesions in the circumflex artery from those in the right coronary artery in inferior STEMI. Pooled data showed a sensitivity of 37%, a specificity of 86%, a PPV of 42%, and an NPV of 83%. Conclusion: The absence of aVR STE appears to exclude LMS as the underlying cause in NSTEMI; in the context of anterior STEMI, its presence indicates a culprit lesion in the proximal segment of LAD. [source] Anatomy and quantitation of the subscapular nervesCLINICAL ANATOMY, Issue 6 2007R. Shane Tubbs Abstract Information regarding branches of the brachial plexus can be of utility to the surgeon for neurotization procedures following injury. Sixty-two adult cadaveric upper extremities were dissected and the subscapular nerves identified and measured. The upper subscapular nerve originated from the posterior cord in 97% of the cases and in 3% of the cases directly from the axillary nerve. The upper subscapular nerve originated as a single nerve in 90.3% of the cases, as two independent nerve trunks in 8% of the cases and as three independent nerve trunks in 1.6% of the cases. The thoracodorsal nerve originated from the posterior cord in 98.5% of the cases and in 1.5% of the cases directly from the proximal segment of the radial nerve. The thoracodorsal nerve always originated as a single nerve from the brachial plexus. The lower subscapular nerve originated from the posterior cord in 79% of the cases and in 21% of the cases directly from the proximal segment of the axillary nerve. The lower subscapular nerve originated as a single nerve in 93.6% of the cases and as two independent nerve trunks in 6.4% of the cases. The mean length of the lower subscapular nerve from its origin until it provided its branch into the subscapularis muscle was 3.5 cm and the mean distance from this branch until its termination into the teres major muscle was 6 cm. The mean diameter of this nerve was 1.9 mm. The mean length of the upper subscapular nerve from its origin to its termination into the subscapularis muscle was 5cm and the mean diameter of the nerve was 2.3 mm. The mean length of the thoracodorsal nerve from its origin to its termination into the latissimus dorsi muscle was 13.7 cm. The mean diameter of this nerve was 2.6 mm. Our hopes are that these data will prove useful to the surgeon in surgical planning for potential neurotization procedures of the brachial plexus. Clin. Anat. 20:656,659, 2007. © 2007 Wiley-Liss, Inc. [source] Separation between the digestive and the respiratory lumina during the human embryonic period: morphometric study along the tracheo-oesophageal septumJOURNAL OF ANATOMY, Issue 1 2001JOSEP NEBOT-CEGARRA An isolated tracheo-oesophageal fistula could be caused by close proximity of the epithelia of both organs (O'Rahilly & Müller, 1984; Kluth et al. 1987) at certain embryonic stages, the most frequent location being the tracheal bifurcation. Thus the relative position and degree of separation between the digestive and the respiratory tubes throughout their development may be relevant to the origin of this anomaly. The aim of this study was to analyse along the different segments of the tracheo-oesophageal septum (TES) where the closest relationship between both lumina occurred and what degree of separation was present at each segment. Computer imaging techniques were applied on cross sections of a graded series of normal human embryos (Carnegie stages (CS) 13,23). In addition, the differentiation of the primitive TES was also studied (from CS 12) by light microscopy. Between CS 13 and 16 both tubes tended to separate (phase of separation), principally at the proximal segments of the laryngopharyngeal and the tracheo-oesophageal portions of the TES. During this phase the separation between the trachea and oesophagus was wider than between the larynx and pharynx. From CS 17 to CS 23 the digestive and respiratory lumina reached their widest separation at different levels of the laryngopharyngeal portion. Below these levels they tended to come closer together, principally at the proximal segment of the tracheo-oesophageal portion, but also at the distal part of the laryngopharyngeal portion. During this phase of approximation they reached their closest relationship at the proximal (CS 17) and the distal (from CS 18) segments of the tracheo-oesophageal portion. When finally the distal segment of the trachea (which includes the bifurcation) comes closest to the oesophagus, the coats of both organs have already undergone an appreciable differentiation. According to these observations, the origin of the most frequent isolated tracheo-oesophageal fistula at the bifurcation region could not be explained from the normal development of the TES. [source] Contractile properties of the proximal urethra and bladder in female pig: Morphology and functionNEUROUROLOGY AND URODYNAMICS, Issue 1 2006J.J.M. Pel Abstract Aims To compare the contractile properties of proximal urethral and bladder muscle of the female pig. Materials and Methods In two proximal segments (I and II) of the urethra, small muscle bundles were excised to measure the force-length (maximum force) and the force-velocity (unloaded shortening velocity) relation using the stop-test. The rate of force development was calculated using phase plots. Contractile properties of urethral and bladder segments were statistically compared using the Mann,Whitney U -test. Immunohistochemical staining of whole circumference urethral cross sections was used to identify the location of smooth and striated muscle fibres. Results On isometric force development, the urethral muscle bundles revealed a fast (,0.5 sec) and a slow (,2.1 sec) time constant, whereas in bladder only a slow (,2.3 sec) component was measured. On average, isometric force was highest in bladder. The length range over which force was produced was smallest in urethral segment II, followed by urethral segment I and finally bladder. The unloaded shortening velocity was 0.15, 0.25 and 0.35 1/sec, respectively. Histological preparations showed that smooth as well as striated muscle was present in proximal urethra. In urethral muscle bundles, spontaneous contractions were measured with a frequency of 0.4 Hz. Conclusions Differences in contractility found between urethra and bladder may be ascribed to the presence of striated muscle in the proximal urethra. The regulation of tone and spontaneous contractions may be part of the continence mechanism in the female pig urinary tract. © 2005 Wiley-Liss, Inc. [source] | |||||||||||||