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At least 1,333 records · Page 74Linked to original sources
PubMed2004

Association between cribbing and entrapment of the small intestine in the epiploic foramen in horses: 68 cases (1991-2002).

OBJECTIVE: To determine whether there was an association between a history of cribbing and epiploic foramen entrapment (EFE) of the small intestine in horses. DESIGN: Retrospective study. ANIMALS: 68 horses examined at the University of Illinois or the University of Liverpool veterinary teaching hospitals. PROCEDURE: For horses examined at the University of Illinois that underwent surgery because of strangulating small intestine lesions, information about cribbing was obtained through telephone calls with owners. For horses examined at the University of Liverpool that underwent surgery for colic for any reason, information about cribbing was obtained through a preoperative questionnaire. RESULTS: 13 of 19 (68%) horses with EFE examined at the University of Illinois had a history of cribbing, compared with only 2 of 34 (6%) horses with other strangulating small intestine lesions (odds ratio, 34.7; 95% confidence interval, 6.2 to 194.6). Similarly, 24 of 49 (49%) horses with EFE examined at the University of Liverpool had a history of cribbing, compared with 72 of 687 (10.5%) horses with colic caused by other lesions (odds ratio, 8.2; 95% confidence interval, 4.5 to 15.1). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that there may be an association between cribbing and EFE in horses, with horses with a history of cribbing more likely to have EFE than horses without such a history.

Animals↗
PubMed2005

Short-term survival after surgery for epiploic foramen entrapment compared with other strangulating diseases of the small intestine in horses.

REASONS FOR PERFORMING STUDY: Epiploic foramen entrapment (EFE) is one of the more common causes of colic in horses, but recent reports suggest a poor prognosis after surgical treatment. HYPOTHESIS: That EFE has a good prognosis compared with other small intestinal strangulating lesions. METHODS: Surgical findings, surgical procedures and short-term outcome were recorded for 157 horses that underwent surgery for strangulating lesions of the small intestine at the University of Illinois from 1994 to 2003. Horses were assigned to 3 groups for comparison; those with EFE, strangulation by lipoma and miscellaneous strangulating lesions. A logistic regression model and Monte Carlo tests of the binomial proportions were used to examine survival rates. The Kruskal-Wallis test was used to determine differences in usage of surgical treatments. Measurements of length and viability indices were analysed using a one-way analysis of variance followed by Tukey's HSD test, and viability scores were analysed using an exact Kruskal-Wallis test. Significance was set at P < 0.05. RESULTS: Horses with EFE were significantly more likely to be discharged (95%) than those with the other conditions (P < 0.05). The proportion of horses with ileal involvement was greater in horses with EFE than in the other 2 groups (P < 0.05), although this did not affect outcome. The distributions of viability grades for EFE and lipoma differed significantly (P < 0.05). CONCLUSIONS: The prognosis for horses that had surgery at this hospital for EFE was better than for those with the other conditions, although the greater proportion of horses with EFE with ileal involvement could influence outcome. Therefore, surgeons must consider ways of improving jejunocaecostomy and determining when bowel is viable, the latter to avoid jejunocaecostomy.

Analysis of Variance↗
PubMedDate not supplied

Ependymoma of the foramen of Monro: ultrastructural characterization.

The characteristics of clear cells of an ependymoma of the foramen of Monro have been studied by electron microscopy to precisely define its organellar composition and to establish the tumor histogenesis. Our data confirm that the once-thought oligodendroglial is, in fact, an ependymal tumor. Both the scarce number of organelles, owing to the low degree of differentiation, and the abundance of hyaloplasmic lipid vacuoles can account for the clear appearance of these tumor cells.

Adult↗
PubMed1985

Amyloidomas in the cerebellopontine angle and jugular foramen. Case report.

The 47-year-old man reported here showed large encapsulated masses in the left cerebellopontine angle and 6 years later in the enlarged left jugular foramen. Histologically, the tumors demonstrated a large deposit of amyloid composed of immunoglobulin light chain-derived proteins (AL). There was no evidence of chronic inflammatory or infectious processes or immunoglobulin abnormalities.

Amyloidosis↗
PubMed1988

The widened transcochlear approach to jugular foramen tumors.

The authors describe a widened transcochlear approach for large tumors of the jugular foramen with intrapetrous, intracranial, and infratemporal extensions. This approach complements the transcochlear and infratemporal approaches by enlarging the route of access to the region with disinsertion of the sternocleidomastoid, digastric, and stylohyoid muscles, by removing petrous bone in order to displace the facial nerve, by resection of the auditory canal, and by subluxation of the temporomandibular joint and zygomatic process. The use of this approach is described in seven patients.

Brain Neoplasms↗
PubMed2001

Patent foramen ovale transcatheter closure device thrombosis.

The role of patent foramen ovale (PFO) in patients with cryptogenic stroke (stroke of unknown cause) remains controversial, although an association seems likely in younger patients with atrial septal aneurysms and PFO. The mechanism of cryptogenic stroke in these patients is presumed to be paradoxical embolism via right-to-left shunt across the PFO. The available options for treatment include medical therapy with antiplatelet or anticoagulant therapy or closure of the PFO surgically or with use of transcatheter PFO closure devices. We describe 2 cases of bilateral device thrombosis associated with use of a transcatheter PFO closure device (CardioSEAL). To our knowledge, only 1 other case of thrombosis associated with use of this device has been reported.

Catheterization↗
PubMed2004

Intracardiac echocardiographic guidance during transcatheter device closure of atrial septal defect and patent foramen ovale.

OBJECTIVES: To describe our experience with intracardiac echocardiographic (ICE) guidance during transcatheter device closure of atrial septal defect (ASD) and patent foramen ovale (PFO) and to describe a detailed stepwise approach for performing ICE examinations. PATIENTS AND METHODS: We reviewed the ICE results of all patients who underwent transcatheter device closure of ASD/PFO at the Mayo Clinic in Rochester, Minn, between October 2000 and November 2002. Conscious sedation was used, and all ICE studies were performed using a diagnostic ultrasound catheter. RESULTS: Ninety-four patients (47 male; median age, 51 years [range, 17-81 years]) underwent ICE during transcatheter device closure of ASD/PFO. Total procedure time was 128 minutes (range, 27-320 minutes). ICE identified a previously unrecognized anatomical diagnosis in 32 of 94 patients. An additional ASD or PFO was found in 16 patients; a redundant atrial septum or an atrial septal aneurysm was found in 12 patients. There were few ICE complications (4%): 3 patients developed atrial fibrillation, and 1 developed supraventricular tachycardia; of these 4, 2 resolved spontaneously, and 2 required cardioversion with no recurrence. CONCLUSION: ICE provides anatomical detail of ASD/PFO and cardiac structures facilitating congenital cardiac interventional procedures. ICE eliminates major drawbacks related to the use of transesophageal echocardiographic guidance for transcatheter device closure of ASD/PFO, specifically problems related to airway management. Finally, ICE gives the interventional cardiologist the ability to control all aspects of imaging without relying on additional echocardiographic support. We believe that ICE should be considered the preferred imaging technique for guidance of transcatheter device closure of ASD/PFO in adults and larger pediatric patients.

Adolescent↗
PubMed2004

Transcatheter Amplatzer device closure of atrial septal defect and patent foramen ovale in patients with presumed paradoxical embolism.

OBJECTIVE: To review our experience with, and profile the safety and efficacy of, the Amplatzer PFO (patent foramen ovale) occluder (APO) and Amplatzer septal occluder (ASO) used to close PFO and/or atrial septal defect (ASD) in patients with paradoxical embolism (PE). PATIENTS AND METHODS: Between April 1998 and November 2002, 103 patients at the Mayo Clinic in Rochester, Minn, and Scottsdale, Ariz, mean age 52.4 years, with presumed PE (transient ischemic attack [n=22], stroke [n=77], or peripheral emboli [n=4]) underwent transcatheter device closure of PFO (n=81), ASD (n=12), and ASD/PFO (n=10) with 106 devices (APO [n=22] or ASO [n=84]). RESULTS: All devices deployed successfully, and no patients died. Procedural complications included atrial fibrillation (n=2), vessel injury (n=3), profound sinus node dysfunction (n=1), and device embolization with successful retrieval (n=1). At 3 months, 7 of 95 monitored patients had trivial residual shunt; at 12 months, 2 of 28 monitored patients had trivial residual shunt. Three patients had recurrent events--2 transient ischemic attacks and 1 retinal artery occlusion--at a mean +/- SD follow-up of 8.3 +/- 8.1 months (range, 1-34 months). None of these 3 patients had residual shunt or evidence of intracardiac thrombus. The average annual recurrence of all events was 3.6% at 23 months. The overall mean +/- SD freedom from recurrence of all events was 98.9% +/- 1.2% and 83.8% +/- 10.2% at 12 and 29 months of follow-up, respectively. CONCLUSIONS: Transcatheter device closure of PFO and/or ASD with use of APO/ASO in patients with presumed PE is effective and safe. Recurrent events may occur in the absence of a residual shunt.

Adult↗
PubMed2004

Patent foramen ovale and stroke.

A patent foramen ovale (PFO) is a frequent remnant of embryological development with clinical importance in thromboembolism, paradoxical embolism, stroke, platypnea-orthodeoxia, decompression sickness, and migraine headache. The proposed mechanisms of stroke with PFO include paradoxical embolization, in situ thrombosis within the canal of the PFO, associated atrial arrhythmias, and concomitant hypercoagulable states. Prospective trials using aspirin treatment to reduce recurrent stroke showed a significant recurrence of neurologic events in patients with a PFO and atrial septal aneurysm. Use of warfarin anticoagulation does not further reduce recurrent stroke rates compared with antiplatelet therapy. Both surgical and catheter-based modes of closure have been shown to decrease the rate of subsequent embolic events substantially. Successful closure, defined by transesophageal echocardiography, appears to predict freedom from subsequent embolic events. To our knowledge, no randomized trials comparing anticoagulation with surgical or catheter-based closure have been performed.

Echocardiography, Transesophageal↗
PubMed2006

Paradoxical emboli in children and young adults: role of atrial septal defect and patent foramen ovale device closure.

OBJECTIVE: To describe a multicenter experience with patent foramen ovale (PFO) and atrial septal defect (ASD) device closure for presumed paradoxical emboli in children and young adults (<35 years old). PATIENTS AND METHODS: Medical records were reviewed of patients who had device closure of an ASD or PFO, who were younger than 35 years, and who had a history of presumed paradoxical embolus between January 1999 and August 2005 at Mayo Clinic, Rochester, Minn, University of Parma, Parma, Italy, and Loyola University Medical Center, Maywood, Ill. RESULTS: Forty-five patients fulfilled the inclusion criteria. Median patient age was 29.0 years (range, 5.0-34.9 years), and 23 patients (51%) were male. Clinical diagnoses included the following: stroke, 30 (67%); transient ischemic attack, 13 (29%); myocardial infarction, 1 (2%); and renal infarct, 1 (2%). Overall, 42 patients (93%) had a PFO, and 3 (7%) had an ASD. Seventeen patients had known cardiovascular disease risk factors: tobacco use (10 patients), hypercoagulable states (7 patients), systemic hypertension (3 patients), and hyperilpidemia (2 patients). No major procedural complications occurred. Median follow-up evaluation was performed at 5.3 months (range, 2.5-40.0 months). Forty-four patients (98%) had no recurrent neurologic events and no residual atrial shunt by contrast transthoracic echocardiography. CONCLUSIONS: Cryptogenic ischemic events occur in young patients and have serious sequelae. The potential for paradoxical embolization through a PFO or an ASD should be assessed in all such patients. In our short-term follow-up, device closure was a safe alternative therapeutic option for children and young adults with presumed paradoxical emboli.

Adolescent↗
PubMed1999

Prevention of recurrent cerebral ischemic events in patients with patent foramen ovale and cryptogenic strokes or transient ischemic attacks.

BACKGROUND: Patent foramen ovale (PFO) is found in up to 50% of patients less than 55 years of age who have had a stroke. Therapeutic options include no therapy, antiplatelet therapy, warfarin and surgical closure of the PFO. OBJECTIVES: To determine the relative and attributable risks of PFO for recurrent cerebral ischemic events in young patients with stroke or transient ischemic attacks. The predictors of recurrent cerebral ischemic events and the effects of different therapies on recurrence rates were sought. DESIGN: Follow-up of a retrospective cohort of patients with cryptogenic stroke or transient ischemic attacks identified from an echocardiography database. SETTING: University-based regional neurology referral centre. PATIENTS: Consecutive group of 90 patients less than 60 years of age who underwent transesophageal echocardiography following a cryptogenic transient ischemic attack (TIA) or stroke (cerebrovascular accident [CVA]) between 1991 and 1997. INTERVENTIONS: Structured telephone interviews and chart reviews. RESULTS: Fifty-two patients had a PFO, and 38 patients did not have a PFO. During a mean follow-up of 46 months, 19 recurrent cerebral ischemic events (12 TIA and seven CVA) occurred in 14 patients with PFO, and eight recurrent events (three TIA and five CVA) occurred in six patients without PFO. The recurrence rates were 12% and 5%/patient/year in the PFO and control groups, respectively, for a crude recurrence rate ratio of 2.39 (95% CI 1.01 to 6.32, P < 0.03). The attributable risk of PFO in recurrent neurological events was 7%/patient/year. In a Cox regression model, predictors of recurrent neurological events were presence of PFO (hazard ratio 5.27, 95% CI 1.58 to 17.6, P < 0.007), history of migraine (hazard ratio 4.54, 95% CI 1.11 to 18.52, P < 0.035), hypertension requiring therapy (hazard ratio 3.5, 95% CI 1.33 to 9.01, P < 0.01), and antiplatelet or no therapy instead of warfarin therapy (hazard ratio 2.88, 95% CI 1.11 to 8.7, P < 0.04). Fourteen patients underwent surgical closure of PFO; there were no neurological recurrences during a mean follow-up of 43 months (crude incidence rate difference 12%/patient/year, 95% CI 6.6 to 17.9, P < 0.02). CONCLUSIONS: Patients with PFO had a significantly higher rate of recurrent cerebral ischemic events than those without PFO. Surgical PFO closure prevented any recurrences during a mean follow-up of 43 months. Warfarin was better than antiplatelet therapy or no therapy in preventing recurrences.

Adolescent↗
PubMed1999

[A case of Morgagni's foramen hernia difficult to differentiate from lipoma].

A 61-year-old woman was admitted for chest discomfort. She had been admitted before, in March 1995, because of a lesion detected on chest roentgenograms. At that time, she was given a diagnosis of mediastinal lipoma based on the findings of chest computed tomography (CT) and magnetic resonance imaging (MRI), but was discharged without active intervention due to lack of subjective symptoms. During follow-up, the patient again reported chest discomfort beginning in March 1998. Because chest radiography disclosed. The tumor had enlarged, the patient was admitted to the hospital by our department. Chest MRI disclosed a mass with a signal intensity equal to that of subcutaneous fat in the pericardial space on both T1-weighted and T2-weighted images. Although sagittal images demonstrated continuity of the mass into intraperitoneal fat, a conclusive diagnosis of diaphragmatic hernia could not be made at that time. On April 30, 1998, a thoracotomy was performed on the basis of a preoperative diagnosis of mediastinal lipoma. During surgery, a hernial ring was observed slightly to the right and behind the sternum. The hernia consisted only of greater omentum, and was diagnosed as Morgagni's foramen hernia.

Diagnosis, Differential↗
PubMedDate not supplied

Patent foramen ovale and implantable cardioverter defibrillator.

A case of patent foramen ovale opening was observed concomitantly to a defibrillation threshold determination in the setting of an internal cardioverter defibrillator implantation. The subsequent transient right-to-left shunt was confirmed by a peroperative transoesophageal echocontrast study. The underlying mechanism of this incident may be related to a transient reversal of the interatrial gradient, due to the pre-existence of pulmonary hypertension and tricuspid regurgitation, associated with ongoing mechanical ventilation and modifications of intracardiac pressures regimen secondary to the succeeding ventricular tachyarrhythmia and defibrillation. Paradoxical embolism can be an aetiology for neurologic injury during internal cardioverter defibrillator implantation.

Defibrillators, Implantable↗
PubMed1976

Cochleo-vestibular manifestations of jugular foramen pathologies.

Patients presenting pathologies of the jugular foramen are presented, for whom the main symptoms are of cochleo-vestibular nature. A classification of the various pathologies is attempted, the anatomy reviewed and hypotheses capable of producing the symptom elaborated.

Adult↗
PubMed1999

[Retroperitoneal lipoma through the foramen of Bochdalek detected as a mass of chest roentgenogram: report of a case].

Retroperitoneal lipomas are relatively uncommon. They are generally asymptomatic tumors. We experienced a 70-year-old man who had retroperitoneal lipoma detected as a mass of chest roentgenogram. Transcutaneous needle biopsy yielded a diagnosis of lipoma. We performed surgical resection because the tumor was growing. The complete resection of the tumor was done uneventfully. The pathological diagnosis of the tumor was benign mature lipoma. The sagittal view of the chest MRI gave precise and useful anatomical informations. This tumor was considered to originate from the retroperitoneal fatty tissue at the subdiaphragmatic region and to extend into the posterior mediastinum though the foramen of Bochdalek. We present herein this case because of a unique growing form, which is the first report in the Japanese literature to our knowledge.

Aged↗