ABSTRACT
Surgical ligation of a left-to-right shunting patent ductus arteriosus was attempted in two animals. In both cases, a young cat and dog, ligation was complicated by poor visualization of the ductus resulting in unsuccessful ligation. Post-operatively, both the cat and dog underwent computed tomography angiography to characterize the location and morphology of the patent ductus arteriosus. In both cases, computed tomography angiography revealed a left-to-right shunting patent ductus arteriosus with an insertion location medial to the left pulmonary artery branch compared to the typical location. We hypothesize that this atypical location resulted in a difficult surgical visualization from the left thoracotomy approach. Transvenous coil embolization of the duct from the external jugular vein was performed in both cases and resulted in successful occlusion. Variations in the medial-lateral insertion of the ductus arteriosus may have consequences for surgical intervention. If an atypical location of a patent ductus arteriosus is suspected on transthoracic echocardiography, computed tomography angiography prior to ligation may be useful to further define ductal location and help guide the surgical approach.
Subject(s)
Cat Diseases , Dog Diseases , Ductus Arteriosus, Patent , Animals , Cat Diseases/surgery , Cats , Computed Tomography Angiography/veterinary , Dog Diseases/diagnostic imaging , Dog Diseases/surgery , Dogs , Ductus Arteriosus, Patent/diagnostic imaging , Ductus Arteriosus, Patent/surgery , Ductus Arteriosus, Patent/veterinary , Echocardiography/veterinary , Ligation/veterinary , Tomography, X-Ray Computed/veterinaryABSTRACT
Allergic contact dermatitis to cement is a delayed-type hypersensitivity reaction in which cytokines interferon-gamma (IEN-y) and vascular endothelial growth factor(VEGF) may be involved in persisting erythema and oedema. VEGF and IFN-gamma levels in serum and skin lesions were measured in 32 Egyptian building workers with chronic allergic contact dermatitis due to occupational exposure to cement and 20 healthy controls. Dermatitis patients had significantly higher levels of serum and lesional skin VEGF and IFN-gamma than controls. A significant positive correlation was found between tissue VEGF and the eczema area and severity index (EASI) score in dermatitis patients (r = 0.86). VEGF and IFN-gamma may play a role in the pathogenesis of cement allergic contact dermatitis.
Subject(s)
Construction Materials/adverse effects , Dermatitis, Allergic Contact/pathology , Dermatitis, Occupational/pathology , Severity of Illness Index , Vascular Endothelial Growth Factor A/analysis , Adolescent , Adult , Biopsy, Needle , Case-Control Studies , Chronic Disease , Dermatitis, Allergic Contact/blood , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/blood , Dermatitis, Occupational/epidemiology , Dermatitis, Occupational/etiology , Down-Regulation/immunology , Egypt/epidemiology , Enzyme-Linked Immunosorbent Assay , Humans , Interferon-alpha/analysis , Interferon-alpha/blood , Interferon-alpha/immunology , Male , Middle Aged , Vascular Endothelial Growth Factor A/blood , Vascular Endothelial Growth Factor A/immunologyABSTRACT
Allergic contact dermatitis to cement is a delayed-type hypersensitivity reaction in which cytokines interferon-gamma [IFN-gamma] and vascular endothelial growth factor [VEGF] may be involved in persisting erythema and oedema. VEGF and IFN-gamma levels in serum and skin lesions were measured in 32 Egyptian building workers with chronic allergic contact dermatitis due to occupational exposure to cement and 20 healthy controls. Dermatitis patients had significantly higher levels of serum and lesional skin VEGF and IFN-gamma than controls. A significant positive correlation was found between tissue VEGF and the eczema area and severity index [EASI] score in dermatitis patients [r = 0.86]. VEGF and IFN-gamma may play a role in the pathogenesis of cement allergic contact dermatitis
Subject(s)
Dermatitis, Contact , Dermatitis, Allergic Contact , Vascular Endothelial Growth Factor A , Severity of Illness IndexABSTRACT
INTRODUCTION: Dysphagia is a common and distressing consequence of hemispheric stroke. STUDY AIM: To verify the usefulness of transcranial magnetic stimulation (TMS) studies of swallowing in healthy subjects and in stroke patients. MATERIAL AND METHODS: TMS studies of the motor cortical projections to the upper esophageal sphincter were performed in 45 patients with acute mono-hemispheric stroke (26 patients with dysphagia) and 20 healthy adult volunteers. RESULTS: TMS of either hemisphere in normal volunteers evoked motor evoked potentials (MEP) in the esophagus. The average point of optimal excitability was slightly more anterior in the right hemisphere; otherwise, MEP amplitudes and latencies were similar from both hemispheres as were the areas of the cortical map. The cortical map area and amplitude of MEPs were significantly smaller and the latencies longer after stimulation of the affected hemisphere compared with the unaffected hemisphere and pooled control data. Twenty-four dysphagic patients (92.3%) had abnormalities of MEP of the affected hemisphere, while only five non-dysphagic patients (26%) had these abnormalities. Dysphagic patients were older and had more disability compared with non-dysphagic patients. MEPs of the affected hemisphere of patients with dysphagia were later and smaller in amplitude than MEPs of non-dysphagic patients. The cortical map area was also smaller. CONCLUSION: The esophagus is represented bilaterally in motor cortex, but the hot spot lies more anterior to Cz in right hemisphere compared to left hemisphere. Both the severity of stroke and neuroplasticity of the unaffected hemisphere have implications in the development of dysphagia.
