scholarly journals Case of successful hybrid revascularization and limb salvage in patient with CLI after multiply ABF thrombosis and absence of outflow arteries

2020 ◽  
pp. 130-142
Author(s):  
A. F. Kharazov ◽  
V. M. Luchkin ◽  
N. M. Basirova ◽  
V. A. Kulbak ◽  
A. I. Maslov
Keyword(s):  
Femoral Artery ◽  
Mechanical Recanalization ◽  
Main Obstacle ◽  
Femoral Arteries ◽  
The Third ◽  
Chronic Occlusion ◽  
First Case ◽  
Anterior Tibial ◽  
Hybrid Revascularization ◽  
Revascularization Procedures

Patients with CLI often present multilevel disease. They underwent multiply revascularization procedures aiming to save thelimb. The main obstacle is absence or poor outflow arteries. Inability to restore bloodflow usuallyleads to ischemia progression and consequent amputation. We describe two cases of successful treatment of patient with CLI after multiply ABF thrombosis and absence of outflow arteries.The first 63 years old patient developed the third case of ABF thrombosis as a result of profunda and superficial femoral arteries chronic occlusion. We performed mechanical recanalization and angioplasty of anterior tibial, popliteal, subintimal recanalization and angioplasty of superficial femoral arteries. After that the ABFleg was sutured to subintimal space of femoral artery. The next case was another 63 years old patient with total chronic occlusion of iliac, femoral, popliteal and tibioperoneal trunk. We performed mechanical recanalization and angioplasty of anterior tibial, popliteal, subintimal recanalization and angioplasty of superficial femoral arteries. And then extra anatomy femoro-femoral autovenous bypass, distal anastomosis was performed by using subintimal artery space also. Thelong term period was 27 months for the first case and 20 months - for the second one. All bypasses were patient.Therefore this described above approach of hybrid open and endovascular surgery could give additional chance forlowlimb revascularization in this so-called hopeless group with criticallimb ischemia.

Penile Lymphoepithelioma-Like Carcinoma: A Rare Case With PD-L1 Expression

2021 ◽  
pp. 106689692098834
Author(s):  
Raquel Machado-Neves ◽  
Bernardo Teixeira ◽  
Elsa Fonseca ◽  
Pedro Valente ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Tumor Cells ◽  
Rare Case ◽  
Malignant Tumors ◽  
Squamous Cell Carcinomas ◽  
The Third ◽  
The Past ◽  
First Case ◽  
Lymphoplasmacytic Infiltrate

Most malignant tumors of the penis are squamous cell carcinomas (SCC), being divided in 2 groups, one human papillomavirus (HPV)-related and another non-HPV-related, with lymphoepithelioma-like carcinoma (LELC) being one of the rarest HPV-related SCC. In this article, we report a case of a 50-year-old man who presented testicular swelling and pain for the past 3 months. A penile mass was identified, and the patient was submitted to a total penectomy. The penectomy specimen showed an ulcerated lesion at the glans reaching the cavernous bodies. Microscopic examination showed undifferentiated epithelial cells with syncytial growth pattern mix with a dense lymphoplasmacytic infiltrate, consistent with LELC. The tumor cells expressed p16 and all 3 different clones of PDL1 (22C3, SP263, and SP142). The patient is alive and well with a follow-up of 3 months. To our knowledge, this is the third LELC of the penis reported in literature and the first case reported with PDL1 expression.

Pricing of Connected and Autonomous Vehicles in Mixed-Traffic Networks

2021 ◽  
pp. 036119812098585
Author(s):  
Paolo Delle Site
Keyword(s):  
Autonomous Vehicles ◽  
Marginal Cost ◽  
User Behavior ◽  
Social Planner ◽  
Traffic Networks ◽  
Mixed Traffic ◽  
The Third ◽  
First Case ◽  
Marginal Cost Pricing ◽  
The Social

For networks with human-driven vehicles (HDVs) only, pricing with arc-specific tolls has been proposed to achieve minimization of travel times in a decentralized way. However, the policy is hardly feasible from a technical viewpoint without connectivity. Therefore, for networks with mixed traffic of HDVs and connected and autonomous vehicles (CAVs), this paper considers pricing in a scenario where only CAVs are charged. In contrast to HDVs, CAVs can be managed as individual vehicles or as a fleet. In the latter case, CAVs can be routed to minimize the travel time of the fleet of CAVs or that of the entire fleet of HDVs and CAVs. We have a selfish user behavior in the first case, a private monopolist behavior in the second, a social planner behavior in the third. Pricing achieves in a decentralized way the social planner optimum. Tolls are not unique and can take both positive and negative values. Marginal cost pricing is one solution. The valid toll set is provided, and tolls are then computed according to two schemes: one with positive tolls only and minimum toll expenditure, and one with both tolls and subsidies and zero net expenditure. Convergent algorithms are used for the mixed-behavior equilibrium (simplicial decomposition algorithm) and toll determination (cutting plane algorithm). The computational experience with three networks: a two-arc network representative of the classic town bypass case, the Nguyen-Dupuis network, and the Anaheim network, provides useful policy insight.

Overview of recent cases before the Court of Justice of the European Union (November 2020-March 2021)

2021 ◽  
pp. 138826272110092
Author(s):  
Pauline Melin
Keyword(s):  
Parental Leave ◽  
The European Union ◽  
Framework Agreement ◽  
The Third ◽  
Court Of Justice ◽  
Rest Periods ◽  
First Case ◽  
Family Benefits ◽  
Grand Chamber ◽  
Italian Legislation

In this reporting period (November 2020-March 2021), five cases will be presented. The first case is INPS v WS (C-302/19), dealing with the Italian legislation that excludes Single Permit holders from receiving family benefits for their family members residing in a third country. In the second report, two cases rendered on the same day by the Grand Chamber of the Court are discussed. In D.J. v Radiotelevizija Slovenija (C-344/19) and RJ v Stadt Offenbach am Main (C-580/19), the Court clarified the circumstances under which periods of stand-by time could be considered as ‘working time’ or, alternatively, ‘rest periods’ under Directive 2003/88. XI v Caisse pour l’avenir des enfants (C-129/20) is the third case reported. It concerns an interpretation of the Framework Agreement on parental leave in the light of the Luxembourg legislation, which requires parents to be employed at the time of their child’s birth to benefit from parental leave. Finally, the case report ends with VL v Szpital Kliniczny im. dra J. Babińskiego Samodzielny Publiczny Zakład Opieki Zdrowotnej w Krakowie (C-16/19), a case of discrimination on grounds of disability.

scholarly journals Effects of posture on shear rates in human brachial and superficial femoral arteries

2008 ◽  
Vol 294 (4) ◽  
pp. H1833-H1839 ◽  
Author(s):  
S. C. Newcomer ◽  
C. L. Sauder ◽  
N. T. Kuipers ◽  
M. H. Laughlin ◽  
C. A. Ray
Keyword(s):  
Shear Rate ◽  
Femoral Artery ◽  
Brachial Artery ◽  
Superficial Femoral Artery ◽  
Upright Posture ◽  
Brachial Artery Diameter ◽  
Shear Rates ◽  
Femoral Arteries ◽  
Lower Shear ◽  
Relative Shear

Shear rate is significantly lower in the superficial femoral compared with the brachial artery in the supine posture. The relative shear rates in these arteries of subjects in the upright posture (seated and/or standing) are unknown. The purpose of this investigation was to test the hypothesis that upright posture (seated and/or standing) would produce greater shear rates in the superficial femoral compared with the brachial artery. To test this hypothesis, Doppler ultrasound was used to measure mean blood velocity (MBV) and diameter in the brachial and superficial femoral arteries of 21 healthy subjects after being in the supine, seated, and standing postures for 10 min. MBV was significantly higher in the brachial compared with the superficial femoral artery during upright postures. Superficial femoral artery diameter was significantly larger than brachial artery diameter. However, posture had no significant effect on either brachial or superficial femoral artery diameter. The calculated shear rate was significantly greater in the brachial (73 ± 5, 91 ± 11, and 97 ± 13 s−1) compared with the superficial femoral (53 ± 4, 39 ± 77, and 44 ± 5 s−1) artery in the supine, seated, and standing postures, respectively. Contrary to our hypothesis, our current findings indicate that mean shear rate is lower in the superficial femoral compared with the brachial artery in the supine, seated, and standing postures. These findings of lower shear rates in the superficial femoral artery may be one mechanism for the higher propensity for atherosclerosis in the arteries of the leg than of the arm.

Low-Grade Mucosa-Associated Lymphoid Tissue Lymphoma Involving the Kidney: Report of 3 Cases and Review of the Literature

2006 ◽  
Vol 130 (1) ◽  
pp. 86-89 ◽  
Author(s):  
Libo Qiu ◽  
Pamela D. Unger ◽  
Robert W. Dillon ◽  
James A. Strauchen
Keyword(s):  
Lymphoid Tissue ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphoid Cells ◽  
Low Grade ◽  
The Third ◽  
First Case ◽  
Abundant Cytoplasm ◽  
History Of

Abstract Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue involving the kidney is rare. We report a series of 3 cases. The first case occurred in an 83-year-old woman who presented with back pain. The second case was a 53-year-old man with a history of sarcoidosis who was found, in the course of evaluation of sarcoidosis, to have a right renal mass. The third case occurred in a 72-year-old man who had a history of periorbital mucosa–associated lymphoid tissue lymphoma and had been treated with surgery and radiation 1 year prior to this presentation. Histologically, all 3 patients showed infiltrate of uniform small-to-medium–sized lymphocytes with irregular nuclear contours and abundant cytoplasm resembling centrocytes or monocytoid lymphoid cells. The first patient received chemotherapy without complications. The second patient underwent a partial nephrectomy and was asymptomatic at the subsequent follow-up. The third patient developed a pulmonary embolism following nephrectomy, and further follow-up is not available.

scholarly journals Childhood renal cell carcinoma

2016 ◽  
Vol 46 (2) ◽  
pp. 93
Author(s):  
Nouval Shahab ◽  
Arry Rodjani ◽  
Rainy Umbas
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumors ◽  
First Report ◽  
The Third ◽  
Knowl Edge ◽  
First Case

Renal cell carcinoma (RCC) in children isseldom found. The incidence of thistumor in childhood is estimated to be 0.1-0.3% out of all neoplasms and 2-7% out ofall malignant renal tumors. The Third NationalCancer Survey reported an incidence of only four casesof RCC per year compared to 117 per year of Wilms’tumor.The incidence of RCC has not been reported inIndonesia. This is the first case of childhood RCCfound in our institution. To the best of our knowl-edge, this is the first report of childhood RCC in In-donesia.

Enhanced release of endothelium-derived factor(s) by chronic increases in blood flow

1988 ◽  
Vol 255 (3) ◽  
pp. H446-H451 ◽  
Author(s):  
V. M. Miller ◽  
P. M. Vanhoutte
Keyword(s):  
Blood Flow ◽  
Smooth Muscle ◽  
Arteriovenous Fistula ◽  
Muscarinic Receptors ◽  
Femoral Artery ◽  
Response Curves ◽  
Femoral Arteries ◽  
Relaxing Factor ◽  
Bioassay System ◽  
Endothelium Derived Relaxing Factor

Chronic increases in blood flow caused by an arteriovenous fistula augment endothelium-dependent relaxations to acetylcholine. To determine whether endothelial muscarinic receptors are altered, concentration-response curves to acetylcholine were obtained in the presence of pirenzepine in fistula- and sham-operated canine femoral arteries. Pirenzepine inhibited the response to acetylcholine in both arteries. The pA2 (log Kb) for the antagonist was the same. A bioassay system was used to assess release of endothelium-derived relaxing factor. Rings of femoral artery (without endothelium) from unoperated dogs relaxed more when superfused with perfusate derived from endothelium of fistula-operated arteries during acetylcholine stimulation. Rings without endothelium of sham- and fistula-operated arteries relaxed to the same extent when superfused with perfusate derived from the endothelium of unoperated femoral arteries. These results suggest that augmented relaxations to acetylcholine in canine arteries where blood flow is chronically elevated do not result from changes in the subtype of endothelial muscarinic receptors or in the sensitivity of the underlying smooth muscle to endothelium-derived relaxing factor(s). They are likely due to increased release of endothelium-derived relaxing factor(s) on muscarinic activation.

Placement of endovascular stents for systemic venous obstruction after the Mustard operation

1994 ◽  
Vol 4 (4) ◽  
pp. 390-394 ◽  
Author(s):  
Jassim M. Abdulhamed ◽  
Saad Al Yousef ◽  
Mohamed A. Ali Khan ◽  
Martin O'Laughlin
Keyword(s):  
Balloon Catheter ◽  
Balloon Dilation ◽  
The Other ◽  
Complete Relief ◽  
Venous Obstruction ◽  
Endovascular Stents ◽  
The Third ◽  
Mustard Operation ◽  
First Case ◽  
Stenotic Area

AbstractThree patients aged five years, five years four months and 14 years with obstruction of the systemic venous baffle following the Mustard operation were treated with balloon dilation and implantation ofstents. Balloon dilation of the baffle obstruction was performed initially in the first two cases. In the third case, the obstruction was complete and was punctured with atranseptal needle via a 6 French transeptal sheath followed by a balloon dilation. in all three patients, a Palmaz stent (Johnson & Johnson, Summerville, New Jersey, USA) was loaded onto the balloon catheter and delivered into the stenotic area. There was complete relief of obstruction in allcases. The first case developed supraventricular tachycardia at the time ofcatheterization, the morning following implantation of the stent and thentwo weeks after that. There were no complications with catheterization and noshort-term side effects in the other cases. These cases illustrate the use of endovascular stents in the treatment of baffle obstruction.

scholarly journals Case report: a 5-year-old with new onset nephrotic syndrome in the setting of COVID-19 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelsi M. Morgan ◽  
Peace D. Imani
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Pediatric Patient ◽  
Corticosteroid Therapy ◽  
Clinical Remission ◽  
Laboratory Findings ◽  
Case Presentation ◽  
The Third ◽  
First Case ◽  
New Onset

Abstract Background This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. Case presentation This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. Conclusions Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.

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