Showing papers by "CHU Ambroise Paré published in 2006"
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TL;DR: There are two venae cavae in humans, one of which comprises the connection of the left and right brachiocephalic veins and ends on the top of the right atrium, after entering the pericardium.
Abstract: There are two venae cavae in humans The superior vena cava (SVC) comprises the connection of the left and right brachiocephalic veins and ends on the top of the right atrium, after entering the pericardium The inferior vena cava (IVC) comprises the connection of the left and right iliac veins and ends on the floor of right atrium, after crossing the diaphragm Whereas the SVC is an intrathoracic vessel, the IVC is an intraabdominal one, its short intrathoracic part being purely virtual Both venae cavae provide venous return to the right heart, approx 25% via the SVC and 75% via IVC [1, 2]
84 citations
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TL;DR: This dissertation aims to provide a history of modern Radiology in Europe and investigates the role of modern equipment, training, and patient expectations in the development of central nervous system disorders.
Abstract: Jafar Golzarian, Elvira Lang, David Hovsepian, Thomas Kroncke, Leo Lampmann, Paul Lohle, Jean-Pierre Pelage, Richard Shlansky-Goldberg, David Valenti, Dierk Vorwerk, James Spies Department of Radiology, 200 Hawkins Drive, 3957 JPP, University of Iowa, Iowa City, Iowa 52242, USA Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA Mallinckrodt Institute, St. Louis, MO 63110, USA Department of Radiology, University Clinic Charit/, Berlin 10117, Germany Department of Radiology, St. Elisabeth Hospital, AN Tilburg 5032, The Netherlands Department of Radiology, Hopital Ambroise Pare, Boulogne 92104 cedex, France University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA Royal Victoria Hospital, McGill University, Montreal, H3A 1A1 Quebec, Canada Department of Diagnosis and Imaging, Klinikum Ingolstadt, Ingolstadt 85049, Germany Georgetown University Medical Center, Washington, DC 20007, USA
28 citations
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TL;DR: The anatomical bases of safe ilio-inguinal (II)-hypogastric anesthesia that can be prolonged into the post-operative period were determined and modified so that it could be used to provide regional anesthesia in five patients operated on for hernia.
Abstract: Although anesthesia and post-operative analgesia are associated with specific morbidity, regional anesthesia is not systematically given during groin hernia surgery. The goals of this work were to determine the anatomical bases of safe ilio-inguinal (II)-hypogastric anesthesia that can be prolonged into the post-operative period and to validate this technique on anatomical preparations and in clinical situations. We studied the courses of the ilio-hypogastric (IH) and II nerves in 33 halves of 20 embalmed adult cadavers. The intermediate portion of the IH and II nerves, located between the transverse and the internal oblique muscles, were found to be suitable for a simultaneous block with a single injection. We assessed the feasibility of injecting a percutaneous infiltration into this space by injecting a dye before dissection. In 75% of cases, we observed percutaneous coloring of the nerves, confirming that this site was suitable. To guide the infiltration, the points where the nerves passed through the transverse and the internal oblique muscles were located from the iliac crest and anterior and superior iliac spine, respectively. The nerve trunks were grouped for over 5 cm in a cell-fat layer running between these two deep muscles. It was possible to position a micro-catheter in this anatomical space to allow repeated injections. The results of this anatomical study were used to modify the technique so that it could be used to provide regional anesthesia in five patients operated on for hernia. Post-operative pain was very effectively controlled in four cases with no complications.
7 citations
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TL;DR: The right HV can be isolated and clamped outside the liver in more than 80% of cases, making it possible to carry out right hepatectomy on an exsanguinous liver.
Abstract: The possibility and value of clamping the right hepatic vein (HV) outside the liver during right hepatectomy remain a matter of debate. We carried out an anatomical study on ten fresh cadaveric subjects with no abdominal scarring or hepatic lesions, to determine the biometry of the extraparenchymatous segment of the right HV. One or several accessory right HVs were found in 90% of cases on release of the right edge of the inferior vena cava (IVC). These accessory right HVs had a diameter greater than that of the superior right HV in 10% of cases. In 70% of cases, the extraparenchymatous segment of the vein was free of collateral branches, and in 30% of cases, it was joined by a branch close to its point of exit from the hepatic parenchyma. The length of the vein that can be clamped (length between the point of exit from the hepatic parenchyma and the point of entry of the right HV into the IVC) was 8.6 ± 1.8 mm (6–12). The right HV entered the vena cava, at an acute angle, in 100% of cases. Clamping of the right HV was possible in all cases. Knowledge of these anatomical points makes it possible to isolate an extraparenchymatous segment of the right HV more safely. The right HV can be isolated and clamped outside the liver in more than 80% of cases, making it possible to carry out right hepatectomy on an exsanguinous liver.
5 citations
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01 Jan 2006TL;DR: Variation in pulse pressure is probably a good parameter for management of fluid requirement in patients with circulatory failure, but reliable use of this parameter is dependent on awareness that there are pitfalls with a strong underlying physiological rationale, especially in an unselected population.
Abstract: Variation in pulse pressure is probably a good parameter for management of fluid requirement in patients with circulatory failure. Its measurement is less invasive than that of other parameters, and several studies have reported its value in clinical practice. However, reliable use of this parameter is dependent on awareness that there are pitfalls with a strong underlying physiological rationale, especially in an unselected population.
3 citations
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01 Jan 2006TL;DR: In this paper, the authors define ICA as "a raparition rapide de symptomes and signes cliniques, allant des signes de congestion a ľetat de choc, secondaires a un fonctionnement altere du coeur".
Abstract: Ľinsuffisance cardiaque aigue (ICA) est definie comme ľapparition rapide de symptomes et de signes cliniques, allant des signes de congestion a ľetat de choc, secondaires a un fonctionnement altere du coeur (1). De nombreux mecanismes peuvent en etre a ľorigine: alteration de la fonction systolique ou diastolique du ventricule gauche (VG) ou du ventricule droit (VD), atteintes valvulaires, maladies du pericarde, desequilibre entre la precharge et la postcharge des ventricules, anomalies du rythme ou de la conduction cardiaque.
2 citations
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01 Jan 2006TL;DR: Marfan syndrome is a genetic disease, the best recognised aetiology of ascending aortic aneurysm, and familial screening is crucial to diagnose the disease before complications have occurred.
Abstract: Marfan syndrome is a genetic disease, the best recognised aetiology of ascending aortic aneurysm. Because of its genetic nature, familial screening is crucial to diagnose the disease before complications have occurred. Regular follow-up with echocardiography should allow timely surgery for aortic root replacement, ideally using a valve-sparing procedure. Beta-blockage and avoidance of violent sports are the mainstay of medical therapy and may delay surgery or even avoid it in some patients. Medical therapy and close follow-up should be maintained after surgery in all patients. Blood pressure control and close follow-up is of upmost importance in patients with persistent dissection of the descending thoracic aorta.