Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Rupture

  • aneurysm rupture
  • bond rupture
  • bronchial rupture
  • cardiac rupture
  • cell rupture
  • intraperitoneal rupture
  • membrane rupture
  • plaque rupture
  • premature rupture
  • preterm premature rupture
  • splenic rupture
  • spontaneous rupture
  • spontaneous splenic rupture
  • surface rupture
  • tendon rupture
  • traumatic rupture
  • tumor rupture
  • uterine rupture
  • wall rupture

  • Terms modified by Rupture

  • rupture process
  • rupture secondary

  • Selected Abstracts


    Tabraze Rasul
    Splenic rupture is a life-threatening condition characterized by internal hemorrhage, often difficult to diagnose. Colonoscopy is a gold standard routine diagnostic test to investigate patients with gastrointestinal symptoms as well as to those on the screening program for colorectal cancer. Splenic injury is seldomly discussed during consent for colonoscopy, as opposed to colonic perforation, as its prevalence accounts for less than 0.1%. A 66-year-old Caucasian woman with no history of collagen disorder was electively admitted for routine colonoscopy for surveillance of adenoma. She was admitted following the procedure for re-dosing of warfarin, which was stopped prior to the colonoscopy. The patient was found collapsed on the ward the following day with clinical shock and anemia. Computed tomography demonstrated grade 4 splenic rupture. Immediate blood transfusion and splenectomy was required. Splenic rupture following routine colonoscopy is extremely rare. Awareness of it on this occasion saved the patient's life. Despite it being a rare association, the seriousness warrants inclusion in all information leaflets concerning colonoscopy and during its consent. [source]


    ANZ JOURNAL OF SURGERY, Issue 6 2007
    Nicolas Venissac MD
    No abstract is available for this article. [source]

    Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

    Salah A.M. Said MD
    ABSTRACT Aims., To delineate the risk factors for rupture of congenital aneurysmal fistulas in adult patients. Methods., We conducted a literature search of the Medline database using Pubmed search interface to identify reports dealing with rupture of congenital aneurysmal fistulas in an adult population. The search included the English and non-English languages between 1963 and 2005. Results., Fourteen adult patients (12 females) with serious and life-threatening complications secondary to aneurysmal fistulas were reported. Mean age was 62.9 years. The ethnic origins of these 14 patients were 9 Asian and 5 Caucasian. Most patients have had no other cardiac malformations. Five patients had a history of hypertension. One patient was asymptomatic. In 13 symptomatic patients, the clinical presentation was cardiac tamponade, pericardial effusion, syncope, heart failure, chest pain, dyspnea, fatigue, distal thromboembolic events with infarction, shock, and/or sudden death. Aneurysmal fistulas were identified in 10 patients; of these 6 were of the saccular type. Rupture occurred in 9 patients (8 females and 1 male). Eleven patients were treated surgically with 1 late death. Two male subjects experienced sudden unexpected cardiac death. Conclusion., Rupture of congenital aneurysmal fistulas occurred more often in females. Identified risk factors for rupture, hemopericardium, tamponade, and death were among others saccular aneurysm, Asian ethnic race, origin of the aneurysmal fistulas from the left coronary artery and a history of hypertension may play a role. In this article, we present a literature review of congenital aneurysmal fistulas associated with or without rupture and a case report of a woman with unruptured aneurysmal fistula. [source]

    Rupture of a Right Sinus of Valsalva Aneurysm into the Right Ventricle During Vaginal Delivery: A Case Report

    ECHOCARDIOGRAPHY, Issue 10 2005
    F.E.S.C., Josip Vincelj M.D., Ph.D.
    A case is reported of a right sinus of Valsalva aneurysm rupture into the right ventricle during vaginal delivery in a 34-year-old healthy woman in her third pregnancy. Pregnancy was carried to term and a healthy baby was delivered vaginally. On day 7 following vaginal delivery she was admitted to hospital for dyspnea and cough, with clinical signs of severe heart failure. The diagnosis of the right sinus of Valsalva aneurysm rupture into the right ventricle was established by transthoracic and transesophageal echocardiography. Clinical recognition and early echocardiographic diagnosis followed by immediate surgical repair proved lifesaving in our patient. (ECHOCARDIOGRAPHY, Volume 22, November 2005) [source]

    Three-Dimensional Echocardiography of Post-Myocardial Infarction Cardiac Rupture

    ECHOCARDIOGRAPHY, Issue 3 2004
    Timothy Puri B.S.
    Ventricular septal defects and pseudoaneurysms are two serious complications of acute myocardial infarction and are associated with a high mortality if not surgically treated. Two-dimensional echocardiography provides excellent diagnostic information in such cases, but three-dimensional echocardiography may provide superior anatomic data of these potentially fatal complications. We describe two cases in which three-dimensional echocardiography provided incremental morphological information. (ECHOCARDIOGRAPHY, Volume 21, April 2004) [source]

    Role of Contrast Echocardiography in the Assessment of Myocardial Rupture

    ECHOCARDIOGRAPHY, Issue 1 2003
    Sumit Mittle M.D.
    Left ventricular free wall rupture is known to complicate acute myocardial infarction and is the second most common cause of inhospital mortality in this patient population. Contrary to widely held medical belief, this does not always result in immediate fatal pericardial tamponade with hemodynamic collapse. Up to 40% of such occurrences are subacute and may evolve over hours or even days. A high index of suspicion and accurate diagnostic tests are required to identify and treat these patients with emergent surgery. Echocardiography has emerged as an important diagnostic modality to identify this catastrophic condition. Although the literature has scattered reports on the role of transesophageal and transthoracic echocardiography in diagnosing free wall rupture, to date, only one report in the literature used ultrasound contrast agents to better delineate echocardiographic findings. We will present two cases in which echocardiography with use of intravenous ultrasound contrast agents was instrumental in helping to exclude rupture in one case and help identify rupture in another. (ECHOCARDIOGRAPHY, Volume 20, January 2003) [source]

    Toward a Reconceptualization of Regional Development Paths: Is Leipzig's Media Cluster a Continuation of or a Rupture with the Past?

    ECONOMIC GEOGRAPHY, Issue 3 2003
    Harald Bathelt
    Abstract: This article develops a model of regional development that is then used to examine the evolution of two media industries in Leipzig, Germany. We note that the city's current media cluster, centered on television/film production and interactive digital media, shares little in common with the city's once-premier book publishing media cluster. Treating interactive learning as the primary causal mechanism that drives economic growth and change, our conceptual framework incorporates both sectoral/technological and political crises as mechanisms that rupture regional development paths. These regional development paths are not homogeneous, but instead consist of bundles of various technological trajectories. Regions recover from crises as their actors continually rebundle local assets until they find a combination that generates growth. As a result of these crises, new opportunities for growth may arise for new and previously marginal industries. In turn, these expanding industries shape the region's development path. [source]

    Rupture of the distal sesamoidean impar ligament with proximal displacement of the distal sesamoid bone in a steeplechaser

    A. G. Heitzmann
    First page of article [source]

    Rupture of chordae tendineae in patients with ,-thalassemia

    Dimitrios Farmakis
    Abstract: Cardiac disease is the primary cause of mortality in , -thalassemia patients. Except for ventricular dysfunction and pulmonary hypertension that represent the main forms of heart disease in these patients, valvular abnormalities including valvular regurgitation, endocardial thickening and calcification and mitral valve prolapse have also been described. Here we present two patients with thalassemia major and mitral chordal rupture, a previously undescribed abnormality in this population. Pathogenesis of this finding may involve thalassemia-related pseudoxanthoma elasticum-like syndrome, a diffuse elastic tissue defect, which is observed with a notable frequency in these patients and has been associated with numerous cardiovascular complications, including valvular ones. [source]

    The Last Will and Testament in Literature: Rupture, Rivalry, and Sometimes Rapprochement from Middlemarch to Lemony Snicket

    FAMILY PROCESS, Issue 4 2008
    Although the psychological literature on the last will and testament is sparse, authors of fiction and memoir have filled the gap, writing in rich detail about the impact of wills on families. Henry James, George Eliot, J. R. Ackerley, and others reveal that a will is not only a legal document but a microcosm of family life: a coded and nonnegotiable message from the will's writer to its intended readers, the heirs, delivered at a stressful time and driving home the truth that options for discussion between testator and heirs are now gone, all factors which may intensify the ambivalence of grief and stall its resolution. Among the problems the authors chronicle: reinvigorated sibling rivalries, vindictive testators, and the revelation of traumatic family secrets. Writers also demonstrate how contemporary social factors, such as divorce, second families, and geographic distance between family members, may complicate wills and ensuing family relations. Exemplary wills, or will-like documents, appear in fiction by Maria Katzenbach and Marilynne Robinson, allowing the living to make rapprochements with the dead, and pointing to testamentary strategies clinicians might develop to lead to a resolution of grief. The depth of these writers' accounts allows clinicians to imagine points at which they might productively intervene in matters pertaining to a will. RESUMEN Aunque la literatura psicológica sobre la última voluntad y el testamento es escasa, los autores de ficción y de memorias han llenado ese vación, escribiendo en rico detalle sobre el impacto de los testamentos en las familias. Henry James, George Eliot, J.R. Ackerley y otros, revelan que un testamento no es sólo un documento legal, sino un microcosmos de vida familiar: un mensaje codificado y no negociable de la voluntad de quien lo escribe a sus destinatarios, los herederos, enviado en un momento estresante y haciendo obvio el hecho de que las posibilidades de discutir entre el emisor y sus herederos ya no existen. Todos estos factores pueden aumentar la ambivalencia de la pena y demorar su resolución. Entre todos los problemas, los autores relatan: aumento de la rivalidad entre hermanos, testamentos vengativos, y la revelación de secretos de familia traumáticos. Los autores también demuestran cómo los factores sociales contemporáneos, como el divorcio, segundas familias y la distancia geográfica entre miembros de la familia, pueden complicar los testamentos y las relaciones familiares posteriores. Testamentos ejemplarizantes, o documentos con aspecto de testamento, aparecen en los trabajos de ficción de Maria Katzenbach y Marilynne Robinson, permitiendo a los vivos acercarse a los muertos, y señalando estrategias testamentarias que los profesionales de clínica pueden desarrollar con el fin de acabar con la pena. La profundidad de los relatos de estos autores permite a los profesionales de clínica imaginarse puntos en que pueden intervenir de una forma productiva en temas relacionados con testamentos. Palabras clave: última voluntad y testamento, muerte, secretos, Henry James, George Eliot, Marilynne Robinson, J.R. Ackerley, Dorothy Gallagher, Maria Katzenbach [source]

    A Generalized System for Photoresponsive Membrane Rupture in Polymersomes

    Neha P. Kamat
    Abstract Polymersomes are vesicles whose membranes comprise self-assembled block copolymers. It has recently been shown that co-encapsulating conjugated multiporphyrin dyes in a polymersome membrane with ferritin protein in the aqueous lumen confers photolability to the polymersome. In the present study, the photolability is shown to be extendable to vesicles containing dextran, an inert and inexpensive polysaccharide, as the luminal solute. How structural features of the polymersome/porphyrin/dextran composite affect its photoresponse is explored. Increasing dextran molecular weight, decreasing block copolymer molecular weight, and altering fluorophore-membrane interactions results in increasing the photoresponsiveness of the polymersomes. Amphiphilic interactions of the luminal encapsulant with the membrane coupled with localized heat production in the hydrophobic bilayer likely cause differential thermal expansion in the membrane and the subsequent membrane rupture. This study suggests a general approach to impart photoresponsiveness to any biomimetic vesicle system without chemical modification, as well as a simple, bio-inert method for constructing photosensitive carriers for controlled release of encapsulants. [source]

    Microencapsulation: Restoration of Conductivity with TTF-TCNQ Charge-Transfer Salts (Adv. Funct.

    Rupture of a mixture of core,shell microcapsules containing tetrathiafulvalene (TTF) and, separately, tetracyanoquinodimethane (TCNQ) in solution results in the formation of the conductive TTF-TCNQ charge-transfer salt. On page 1721, J. S. Moore and co-workers used this initially non-conductive microcapsule system to restore electrical conductivity to a damaged gold circuit upon microcapsule rupture. Illustration provided by Alex Jerez. [source]

    Restoration of Conductivity with TTF-TCNQ Charge-Transfer Salts

    Susan A. Odom
    Abstract The formation of the conductive TTF-TCNQ (tetrathiafulvalene,tetracyanoquinodimethane) charge-transfer salt via rupture of microencapsulated solutions of its individual components is reported. Solutions of TTF and TCNQ in various solvents are separately incorporated into poly(urea-formaldehyde) core,shell microcapsules. Rupture of a mixture of TTF-containing microcapsules and TCNQ-containing microcapsules results in the formation of the crystalline salt, as verified by FTIR spectroscopy and powder X-ray diffraction. Preliminary measurements demonstrate the partial restoration of conductivity of severed gold electrodes in the presence of TTF-TCNQ derived in situ. This is the first microcapsule system for the restoration of conductivity in mechanically damaged electronic devices in which the repairing agent is not conductive until its release. [source]

    Rupture of radiation-induced internal carotid artery pseudoaneurysm in a patient with nasopharyngeal carcinoma,Spontaneous occlusion of carotid artery due to long-term embolizing performance,

    Kai-Yuan Cheng MD
    Abstract Background Rupture of internal carotid artery (ICA) pseudoaneurysm is a lethal complication in patients with nasopharyngeal carcinoma (NPC). Angiography is the best diagnostic and treatment method. The aim of embolization is to block the pseudoaneurysm; but sometimes, total occlusion of great vessels is ineludible. We describe a case of NPC post-radiation therapy and with ruptured pseudoaneurysm treated by angio-embolization. Methods The patient had received embolization with numerous tools such as stent grafts, balloons, and bare stents with or without filter protection. Results After failing to pass through the narrow lumen by embolizing tools, the right ICA finally occluded spontaneously by self-thrombosis. Conclusion Although the angio-embolization is a good method to resolve the problems of ruptured pseudoaneurysm, there is still high mortality and morbidity. Being aware of the clinical presentations and the changes of images may alert us to predict the happening earlier. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source]

    Spontaneous Rupture of a Nonaneurismatic Ascending Thoracic Aorta

    Mariano E. Brizzio M.D.
    We report a case of spontaneous rupture of the ascending aorta treated successfully. While the etiology is still unclear, diagnosis with bedside transesophageal echocardiography prompted emergent surgical intervention. [source]

    Delayed Rupture of the Left Ventricle Inferior Wall: A Diagnostic and Surgical Challenge

    Minoo N. Kavarana M.D.
    The etiology, factors contributing to the delayed presentation, diagnosis, and management are discussed. [source]

    Rupture of the Innominate Artery from Blunt Trauma: Current Options for Management

    John D. Symbas M.D.
    It is frequently accompanied by major trauma to other organs. The traditional management is expeditious surgical repair. Methods: Three patients presented to the Emergency Department after motor vehicle collisions with traumatic rupture of the innominate artery from 2001 to 2003. One patient presented with an isolated innominate artery injury. The other two patients presented with multi-system trauma. All patients underwent surgical repair; however, repair was individualized in each case. Results: Diagnosis was obtained via arteriography in all patients after the admission chest radiographs suggested mediastinal injury. In the patient with isolated traumatic innominate artery rupture, urgent repair was performed. In the remaining two, the repair was intentionally delayed (hospital day 4 and 19) until they stabilized or recovered from other injuries or complications. In one of these patients, repair was delayed after an endovascular repair failed. In both patients who underwent delayed repair, mean arterial pressure was maintained at <70 mmHg with beta-blockade. All patients underwent repair without cardiopulmonary bypass and were monitored for adequate cerebral perfusion pressures by measuring the right carotid artery stump pressure. Successful repair was achieved in all the three patients without postoperative complications or mortality. Conclusions: Rupture of the innominate artery from blunt trauma is an infrequent but life-threatening injury that mandates repair. In patients with isolated injuries, prompt intervention is warranted. However, intentional delayed repair may be a practical alternative for those patients with multi-system trauma. [source]

    Sonographic appearance of ruptured ovarian cyst in the neonatal period

    Thomas A. Gallagher MD
    Abstract Rupture is a rare complication of ovarian cysts diagnosed during the prenatal period. We present a case that focuses on the postnatal sonographic appearance of rupture of an ovarian cyst after vaginal delivery. Histopathologic correlation is provided. The main sonographic features include complicated ascites and a collapsed cystic structure in the abdomen. Ruptured ovarian cyst should be included in the differential diagnosis of unexplained ascites in a newborn girl. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source]

    Cardiac tamponade caused by spontaneous rupture of mediastinal lymph node metastasis of hepatocellular carcinoma

    Shuichi Seki
    Abstract Rupture of a hepatocellular carcinoma (HCC) is a well-known cause of death in patients with HCC. This report describes a rare case of HCC presenting as cardiac tamponade caused by a spontaneous rupture of mediastinal lymph node metastasis into the pericardial space. A transcatheter arterial embolization (TAE) of internal thoracic artery successfully controlled the bleeding, and the patient was rescued from cardiac tamponade. Although there was no rebleeding, the patient died from liver failure 2 months later. An autopsy revealed a poorly differentiated HCC in the liver, lung and mediastinal lymph nodes. [source]

    Life-threatening haemorrhage from a sternal metastatic hepatocellular carcinoma

    Chih-Yen Chen
    Abstract Rupture of the tumour is a catastrophic complication of hepatocellular carcinoma. The prognosis in patients with a ruptured hepatocellular carcinoma is usually unfavourable. We describe a 46-year-old man who suffered from visible massive tumour haemorrhage due to a hepatitis B-related hepatocellular carcinoma that metastasized to the sternal bone. The prominent tumour mass was bulging over the anterior chest wall on the sternum of the patient, and bled spontaneously. This episode of life-threatening haemorrhage was stopped by surgical ligation of the bleeding site. Palliative radiotherapy shrank the tumour mass size and prevented further possible bleeding. This is likely to be the first reported case with a visible spontaneous tumour bleeding from a sternal metastatic hepatocellular carcinoma. [source]

    Self-assembly and recrystallization of bacterial S-layer proteins at silicon supports imaged in real time by atomic force microscopy

    E. S. Györvary
    Summary The self-assembly of bacterial surface-layer (S-layer) proteins (SbpA of Bacillus sphaericus CCM 2177) at silicon supports (hydrophobic, non-plasma-treated and hydrophilic, O2 plasma-treated silicon supports) was imaged in real time by atomic force microscopy (AFM). A closed mosaic layer consisting of small crystals (less than 200 nm in diameter) was formed at a hydrophobic silicon support, whereas a coherent crystalline lattice consisting of large domains (2,10 µm in size) was generated at O2 plasma-treated, hydrophilic silicon wafers. The structure of the formed layers was a monolayer (9 nm in height) at the hydrophobic silicon and a bilayer (15 nm in height) at the hydrophilic silicon. In situ AFM measurements confirmed the importance of ionic bonds in the formation of crystalline SbpA layers at silicon supports. Rupture of the protein subunits with a metal chelator from the crystalline lattice of SbpA was visualized in situ by AFM. The stability of solid-supported SbpA layers could be enhanced by cross-linking the S-layers with amino,amino or amino,carboxyl group directed cross-linkers. [source]

    Can Women At Term Self-Diagnose Premature Spontaneous Rupture of Membranes?

    William A. Alto MD
    No abstract is available for this article. [source]

    Neonatal C-reactive protein value in prediction of Outcome of Preterm Premature Rupture of Membranes: Comparison of Singleton and Twin Pregnancies

    Simin Taghavi
    Abstract Aim:, The clinical importance of preterm premature rupture of the membranes (PPROM) is its relationship to maternal and neonatal mortality and morbidity, especially in twin pregnancies. The aim of this study was to determine and compare the role of inflammatory factors as predictors of the PPROM outcome between singleton and twin pregnancies. Methods:, The medical records of 22 twins delivered between 28 and 34 weeks and complicated by PPROM were reviewed at the Al-Zahra Hospital in Tabriz, Iran. Also among singletons, 55 cases of matched gestational age were randomly selected as a control group. Three laboratory indices of neonatal white blood cell (WBC) count and C-reactive protein (CRP) in the two groups were measured immediately after delivery and the effects of two factors on neonatal outcome were assessed. Results:, In singletons, there was adverse relationship between the mean of WBC count and duration of latency (P = 0.007). Also, a positive relationship between the means of ventilation time and WBC count in second twins was found (P = 0.034). Positive CRP was the main predictor of neonatal intensive care unit admission in both singletons (odds ratio: 4.929, P = 0.042) and first twins (odds ratio: 9.000, P = 0.005). However, positive CRP did not influence the existence of metabolic acidosis or duration of latency in either of the two groups. Conclusion:, Neonatal WBC count was a predictor for the duration of latency in singletons and for ventilation time in twins. Positive neonatal CRP was an important factor for the prediction of neonatal intensive care unit admission in both types of pregnancy; its role in twins is clearer than in singletons. [source]

    Post Partum Splenic Artery Aneurysm Rupture

    Dr. S. Asokan
    Abstract Ruptured splenic artery aneurysm during pregnancy is a rare event with high maternal and fetal mortality rate. A case of ruptured splenic artery aneurysm in the post partum period is presented. The literature is reviewed on pathophysiology, clinical presentation and management of this rare and potentially fatal entity. [source]

    Complementary roles of platelets and coagulation in thrombus formation on plaques acutely ruptured by targeted ultrasound treatment: a novel intravital model

    Summary.,Background:,Atherothrombosis is a major cause of cardiovascular events. However, animal models to study this process are scarce. Objectives:,We describe the first murine model of acute thrombus formation upon plaque rupture to study atherothrombosis by intravital fluorescence microscopy. Methods:,Localized rupture of an atherosclerotic plaque in a carotid artery from Apoe,/, mice was induced in vivo using ultrasound. Rupture of the plaque and formation of localized thrombi were verified by two-photon laser scanning microscopy (TPLSM) in isolated arteries, and by immunohistochemistry. The thrombotic reaction was quantified by intravital fluorescence microscopy. Results:,Inspection of the ultrasound-treated plaques by histochemistry and TPLSM demonstrated local damage, collagen exposure, luminal thrombus formation as well as intra-plaque intrusion of erythrocytes and fibrin. Ultrasound treatment of healthy carotid arteries resulted in endothelial damage and limited platelet adhesion. Real-time intravital fluorescence microscopy demonstrated rapid platelet deposition on plaques and formation of a single thrombus that remained subocclusive. The thrombotic process was antagonized by thrombin inhibition, or by blocking of collagen or adenosine diphosphate receptor pathways. Multiple thrombi were formed in 70% of mice lacking CD40L. Conclusions:,Targeted rupture of murine plaques results in collagen exposure and non-occlusive thrombus formation. The thrombotic process relies on platelet activation as well as on thrombin generation and coagulation, and is sensitive to established and novel antithrombotic medication. This model provides new possibilities to study atherothrombosis in vivo. [source]

    Spontaneous Splenic Rupture due to Plasmodium vivax in a Traveler: Case Report and Review

    Beatriz C. Jiménez MD
    First page of article [source]

    Successful Management of Traumatic Right Atrial Rupture

    Angela L. Witt DVM
    Summary A 2 year old male mixed breed dog presented with clinical signs of acute cardiac tamponade after being hit by a car. Echocardiography confirmed the presence of pericardial effusion. Pericardiocentesis revealed venous blood that clotted normally, suggestive of an acute lesion involving the right side of the heart. An emergency thoracotomy was performed, and a laceration of the right atrium was identified and repaired. Postoperatively, the dog developed traumatic myocarditis that improved with time and medical management. Six months after surgery, the dog was healthy with no adverse effects of the trauma. The importance of early recognition and the necessity for expeditious surgical management of traumatic right atrial rupture in the dog is illustrated in this report. [source]

    Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes

    Daniel B. DiGiulio
    Citation DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok K, Gotsch F, Mazaki-Tovi S, Vaisbuch E, Sanders K, Bik EM, Chaiworapongsa T, Oyarzún E, Relman DA. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre-labor rupture of membranes. Am J Reprod Immunol 2010; 64: 38,57 Problem, The role played by microbial invasion of the amniotic cavity (MIAC) in preterm pre-labor rupture of membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation-based methods. Method of study, Amniotic fluid from 204 subjects with pPROM was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad-range and group-specific polymerase chain reaction (PCR) assays targeted small subunit ribosomal DNA (rDNA), or other gene sequences, from bacteria, fungi, and archaea. Results were correlated with measurements of host inflammation, as well as pregnancy and perinatal outcomes. Results, The prevalence of MIAC was 34% (70/204) by culture, 45% (92/204) by PCR, and 50% (101/204) by both methods combined. The number of bacterial species revealed by PCR (44 species-level phylotypes) was greater than that by culture (14 species) and included as-yet uncultivated taxa. Some taxa detected by PCR have been previously associated with the gastrointestinal tract (e.g., Coprobacillus sp.), the mouth (e.g., Rothia dentocariosa), or the vagina in the setting of bacterial vaginosis (e.g., Atopobium vaginae). The relative risk for histologic chorioamnionitis was 2.1 for a positive PCR [95% confidence interval (CI), 1.4,3.0] and 2.0 for a positive culture (95% CI, 1.4,2.7). Bacterial rDNA abundance exhibited a dose relationship with gestational age at delivery (R2 = 0.26; P < 0.01). A positive PCR was associated with lower mean birthweight, and with higher rates of respiratory distress syndrome and necrotizing enterocolitis (P < 0.05 for each outcome). Conclusion, MIAC in pPROM is more common than previously recognized and is associated in some cases with uncultivated taxa, some of which are typically associated with the gastrointestinal tract. The detection of MIAC by molecular methods has clinical significance. [source]

    Primary Treatment of Ranula With Intracystic Injection of OK-432

    THE LARYNGOSCOPE, Issue 2 2006
    Jong-Lyel Roh MD
    Abstract Objective: Although surgery is the first choice of therapy for ranula, it was made a hypothesis that ranula can be primarily treated with sclerotherapy from prior evidence. This study examined the effectiveness of intracystic injection of OK-432 for treatment of ranula. Method: This prospective clinical study comprised a total of 26 patients with ranula (19 intraoral type; seven plunging type) treated with OK-432 sclerotherapy. Aspirated mucus of ranula was replaced with an equal volume of OK-432 solution of 0.01 mg/mL. The size of ranula was compared before and after sclerotherapy. Results: Twenty of 26 patients (77%) showed a complete response after sclerotherapy: higher in plunging ranula (86%) than in intraoral ranula (74%). Rupture of ranula developed in seven of 19 patients (37%) with intraoral ranula within a few days after injection. The early rupture occurred more frequently in patients having a less-than-marked response and seemed to cause an increase in the total number of OK-432 injections: seven ruptured cases versus 12 nonruptured cases (mean 3.6 versus 1.5, P < .001). Recurrence occurred in two patients during a median follow-up period of 12 months (range, 9,22 mo) after the last injection. There were no major side effects, scarring, or increased morbidity to surgery of the OK-432-injected lesions. Conclusion: The intracystic injection of OK-432 is highly effective as a primary treatment modality of ranula. [source]

    ,asan al-Bann, and Sayyid Qu,b: Continuity or Rupture?

    THE MUSLIM WORLD, Issue 2 2009
    Ana Belén Soage
    First page of article [source]