Abnormal Communication Research Articles

New Insights into Sinus Venosus Defects from Cross-Sectional Imaging

Sinus venosus defects include two varieties, superior and inferior sinus venosus defects. The superior sinus venosus defect is characterized by abnormal communication between two closely related venoatrial structures: 1) the normally positioned superior vena cava-right atrium complex and 2) the right pulmonary vein-left atrium complex that is displaced leftward, forward and upward. Inferior sinus venosus defects primarily involve the inferior vena cava-right atrial junction while the right pulmonary vein-left atrial junction can also be affected. Because of the rarity and wide variation of the defects, the morphological characterization of sinus venosus defects is inconsistent among investigators and often inaccurate. Modern imaging technologies with high spatial and temporal resolutions have allowed accurate and detailed assessment of the pathological anatomy in larger numbers of cases. In this pictorial essay, we revisit the established and controversial features of the sinus venous defects using two-dimensional (2D) and three-dimensional (3D) images obtained by magnetic resonance (MR) or computed tomography (CT) with brief discussion on imaging and treatment strategies.

Syntelencephaly: medial interhemispheric variant of holoprosencephaly

Holoprosencephaly (HPE) is a congenital malformation occurring very early in pregnancy and due to abnormal diverticulation of the prosencephalon. This defect in primary brain cleavage may be total or partial, which explains the anatomopathological variants of holoprosencephaly. The main forms of holoprosencephaly include alobar, semilobar and lobar HPE. Syntelencephaly also known as middle interhemispheric variant (MIHV) is a very rare type of HPE. While in the three most common variants, cleavage defect has antero-posterior gradient of severity, syntelencephaly does not follow this rule. The latter is characterised by abnormal communication between cerebral hemispheres in the posterior and parietal frontal regions, with normal inter-hemispheric separation of the anterior frontal lobes, of the occipital regions and central grey nuclei. The trunk of the corpus callosum is achieved at the level of the knee of the corpus callosum (allowing differentiation from lobar HPE) and of the splenium. An azygos cerebral artery is common, consisting of a fusion of the A1 segments of the anterior cerebral arteries to form a single arterial trunk. Other cerebral malformations may be associated with syntelencephaly, the most frequent being cortical dysplasia and grey matter heterotopia. Facial abnormalities are less common in syntelencephaly compared to classic forms of HPE. Prognosis depends mainly on these malformative associations in the brain and other organs, and even on chromosomal aberrations.

A rare case of nontraumatic bilateral carotid cavernous fistula Barrow type D – A case report

Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the normal carotid arterial system. We are presenting a very rare case of spontaneous nontraumatic bilateral Barrow type D CCF. A 41-year-old patient presented to our tertiary eye care center with a history of long-standing bilateral congested eyes. On imaging, the patient was diagnosed with spontaneous bilateral Barrow type D CCF. The patient improved significantly by treatment with carotid decompression exercises. It is recommended to consider the diagnosis of bilateral CCFs as a differential diagnosis in patients with long-standing history of congested eyes nonresponsive to conventional topical treatment.

The relevance of organelle interactions in cellular senescence.

Organelles are tiny structures with specific functions in eukaryotic cells. Since they are covered with membranes, different organelles can perform biological processes that are incompatible. Organelles can also actively communicate with each other to maintain cellular homeostasis via the vesicular trafficking pathways and membrane contact sites (MCSs), which allow the exchange of metabolites and other information required for normal cellular physiology. An imbalance in organelle interactions may result in multiple pathological processes. Growing evidence shows that abnormal organelle communication contributes to cellular senescence and is associated with organ aging. However, the key role of organelle interactions in aging has not yet been broadly reviewed and fully investigated. In this review, we summarize the role of organelle interactions in cellular senescence, and highlight their relevance for cellular calcium homeostasis, protein and lipid homeostasis, and mitochondrial quality control. Our review reveals important mechanisms of organelle interactions in cellular senescence and provides important clues for intervention strategies from a new perspective.

A Rare Case of Coronary Artery Fistula on Vieussens Arterial Ring

Coronary artery fistulas represent an abnormal communication between coronary circulation and heart chambers or any segment of pulmonary or systemic circulation, without an intervening capillary network. Seldom, this connection can arise on a conotruncal anastomotic variant linking the anterior descending artery and the right coronary artery or a conus artery originating from the right coronary sinus, known as Vieussens’ arterial ring. Here we discuss a case of a 73-yearold man undergoing a coronary CT angiography because of recurrent chest pain and cardiovascular risk factors; the exam showed multiple aneurismatic sacs on a Vieussens arterial ring, associated with a fistulous connection between one of the aneurysms and the main pulmonary artery, highlighted by an hyper dense jet of contrast medium within its lumen. We spotted also enlarged right and left pulmonary arteries and right ventricular dilatation, with a mild hemodynamic overload on echocardiographic evaluation. A coronary angiography confirmed the findings shown by CT scan. After a multidisciplinary discussion, the interventional cardiology team decided to close the fistulous connection. Therefore, in a subsequent procedure the malformation was treated by catheterizing the branch stemming from the anterior descending artery and placing embolization coils in the first aneurysmatic sac and in the vessel itself; the same treatment was performed on the branch originating from the right coronary sinus. Final angiographic control showed complete exclusion of the saccular aneurysms from the circulation and closure of the associated fistula. There was no peri or post-procedural complication.

Medical care and research: Two wings of a great eagle in critical care

Medical care and research: Two wings of a great eagle in critical care

The Brachial Plexus: More and More Variations

The brachial plexus is so variable that most of dissected cases will show some form of anatomical variations. In the same person, the right and left sides are not the same. This study was done to identify the variations of the brachial plexus and highlight their clinical significance. The materials of this study included 10 cadavers dissected on both sides to find out the variations of the different parts of the plexus. Variations were found in 85% of cases. Variations included all stages of the plexus. Phrenic nerve took origin from the upper trunk in 10%, while the lateral pectoral nerve took origin by 2 roots from the upper and middle trunks or from the lateral and medial cords in 40%. Abnormal communications were found between the trunks, cords, or branches. Abnormal relations were found between the trunks, cords, or branches and the subclavian or axillary arteries. It is essential to know the exact anatomy of the brachial plexus prior to surgical repair of brachial plexus injuries or prior to supra or infraclavicular plexus block. Variations of brachial plexus are so common. Researchers have been trying for so long to assign specific patternsfor brachial plexus. Their efforts were inutile and now is the time to acknowledge anatomical variations of brachial plexus as the rule.

Mechanical hemolysis secondary to percutaneous repair of an iatrogenic Gerbode defect with the AmplatzerTM Septal Occluder

The Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium, and is etiologically classified as congenital or acquired (iatrogenic or not). The typical treatment consists of surgical repair of the shunt, but transcatheter occlusion of this condition has proven to be a safe and effective therapeutic alternative for such patients, especially for those with prior surgeries. The aim of this study was to report a case of transcatheter closure of an acquired Gerbode defect, using the Amplatzer™ Septal Occluder device, in a 58-year-old patient, with two prior mitral valve replacements, and the consequent post-procedure mechanical hemolysis.

The Role of Manual Compression in Doppler Ultrasound Mapping of Arteriovenous Vascular Malformations in the Upper and Lower Extremities

Doppler ultrasonography (US) is an important noninvasive technique for diagnosing and assessing arteriovenous malformation (AVM). US, magnetic resonance, computed tomography, and angiograms make it possible to locate and describe these malformations, in particular the nidus. The AVM nidus shows as a high-density tangle of tortuous and dilated vessels (arteries and veins) caused by abnormal communications (AV shunts) between these vessels. Locating these AV shunts precisely within the nidus is difficult. A new manual compression technique used during US exploration allows us to accurately differentiate afferent/efferent vessels from the AV shunts located in the nidus.

Neuromodulation Strategies for the Treatment of Depression

For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of medications and a psychological paradigm resulting in the development of psychotherapies. A third paradigm positing that psychiatric dysfunction results from abnormal communication within a network of brain regions that regulate mood, thought, and behavior has gained increased attention over the past several years and underlies the development of multiple neuromodulation and neurostimulation therapies. This neural circuit paradigm is not new. In the late 19th and early 20th centuries, it was a common way of understanding psychiatric illness and led to several of our earliest somatic therapies. However, with the rise of effective medications and evidence-based psychotherapies, this paradigm went mostly dormant. Its recent reemergence resulted from a growing recognition that medications and psychotherapy leave many patients inadequately treated, along with technological advances that have revolutionized our ability to understand and modulate the neural circuitry involved in psychiatric disorders. In this overview, the authors review the history and current state of neuromodulation for psychiatric illness and specifically focus on these approaches as a treatment for depression, as this has been the primary indication for these interventions over time.

Spontaneous Biliary-Enteric Fistulas and Associated Complications: An Overview.

Spontaneous biliary-enteric fistula (SBEF) is an abnormal communication between the biliary tree and the gastrointestinal tract which develops as a result of biliary or gastrointestinal disease. Iatrogenic fistulas, due to surgery or instrumental exploration, are not included in this definition. R. Colombo, in 1559, was the first to describe SBEF as an occasional finding during an autopsy. In almost 90% of cases the cause of SBEF is chronic recurrent cholelithiasis. Less common causes are penetrating peptic ulcers and neoplastic infiltration from the biliary or gastrointestinal tract. The most common type of SBEF is cholecystoduodenal fistula and the least common is choledochoduodenal fistula. There are various complications associated with SBEF but often these are not promptly recognized by patients or physicians and diagnosis and treatment may be delayed for years. The most important complication, which can be considered pathognomonic for SBEF, is gallstone ileus which manifests clinically as acute or chronic mechanical intestinal obstruction. Gallstone ileus, a rather rare complication of a rather common pathology, biliary lithiasis, is found in 0.000015% of hospitalized patients but in 0.0003% of surgical patients. It is mainly found in women over the age of 65, with a male to-female ratio of 1:5. There are various forms of occlusion, related to the sites of gallstone impaction, with various clinical characteristics and degrees of severity. These include Bouveret syndrome ( 10% of cases) with impaction in duodenum or pylorus, and the more common Barnard's syndrome (5-75% of cases) in which the site of impaction is in the terminal ileum right before Bauhin's valve. For diagnosis, the radiological signs which make up Riglerâ??s triad or tetrad, are essential, and are best visible on magnetic resonance. The the gold standard is contrast-enhanced computed tomography scan. Regarding the surgical management, one-stage simple enterolithotomy is reserved for the oldest patients and the most severe cases. Nowadays, is performed more and more frequently by laparoscopy. In more favorable cases radical treatment of the occlusion, the biliary lithiasis and the SBEF is recommended, either as a one-stage procedure or in two stages with the second procedure performed after few weeks.

Surgical therapy of oronasal fistula: A case report and review of the literature

An oronasal fistula is a rare pathologic entity in everyday clinical practice. It is defined as an abnormal epithelialized communication between nasal and oral cavity and its etiology may be congenital or acquired. Oronasal fistula results in clinical features from the upper respiratory tract and a generalized degrada- tion of the patient’s quality of life. Although a variety of surgical treatment methods has been documented, there are often postsurgical complications with the re- currence of the fistula being the most common. In this case report, the case of a patient with an oronasal fistula located at the labial area of the maxillary who was surgi- cally treated is described and literature review follows.

Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review.

BackgroundCerebrospinal fluid (CSF) rhinorrhea results from abnormal communications between the subarachnoid and sinonasal spaces. Accurate preoperative diagnosis and localization are vital for positive clinical outcomes. However, the diagnosis and localization of CSF rhinorrhea remain suboptimal due to a lack of accurate understanding of test characteristics.ObjectiveThis systematic review aims to assess the diagnostic accuracy of various tests and imaging modalities for diagnosing and localizing CSF rhinorrhea.MethodsA systematic review of the MEDLINE and EMBASE databases was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsOur search identified 4039 articles—53 cohort studies and 24 case series describing 1622 patients were included. The studies were heterogeneous and had a wide range of sensitivities and specificities. Many specificities were incalculable due to a lack of true negative and false positive results, thus precluding a meta-analysis. Median sensitivities and specificities were calculated for cohort studies of the following investigations: high-resolution computed tomography (HRCT) 0.93/0.50 (sensitivity/specificity), magnetic resonance cisternography (MRC) 0.94/0.77, computed tomography cisternography (CTC) 0.95/1.00, radionuclide cisternography (RNC) 0.90/0.50, and contrast-enhanced magnetic resonance cisternography (CEMRC) 0.99/1.00, endoscopy 0.58/1.00, topical intranasal fluorescein (TIF) 1.00/incalculable, intrathecal fluorescein (ITF) 0.96/1.00. Case series were reviewed separately. Etiology and site-specific data were also analyzed.ConclusionMR cisternography is more accurate than high-resolution CT at diagnosing and localizing CSF rhinorrhea. CT cisternography, contrast-enhanced MR cisternography, and radionuclide cisternography have good diagnostic characteristics but are invasive. Intrathecal fluorescein shows promising data but has not been widely adopted for purely diagnostic use. Office endoscopy has limited data but does not sufficiently diagnose CSF rhinorrhea independently. These findings confirm with current guidelines and evidence.

Left circumflex artery pericardia fistula combined with huge pseudoaneurysm: a rare case report

BackgroundCoronary artery fistula refers to an abnormal communication between a coronary artery and great vessel, a cardiac chamber or other structure. The left circumflex artery (LCX) pericardia fistula combined with huge pseudoaneurysm is extremely rare.Case presentationA 39-year-old young female was admitted into our hospital because of palpitation and shortness of breath. Coronary computed tomography angiography (CCTA) showed a huge pseudoaneurysm located in pericardium. Coronary angiography revealed the LCX pericardia fistula. Then surgical treatment was performed. She was in good condition without complications after surgery.ConclusionsCoronary artery fistula combined with pseudoaneurysm can be caused by congenital factors. Early surgical treatment can relieve the patient's symptoms and prevent the occurrence of adverse cardiovascular events.

Developmental decrease of entorhinal-hippocampal communication in immune-challenged DISC1 knockdown mice

The prefrontal-hippocampal dysfunction that underlies cognitive deficits in mental disorders emerges during early development. The lateral entorhinal cortex (LEC) is tightly interconnected with both prefrontal cortex (PFC) and hippocampus (HP), yet its contribution to the early dysfunction is fully unknown. Here we show that mice that mimic the dual genetic (G) -environmental (E) etiology (GE mice) of psychiatric risk have poor LEC-dependent recognition memory at pre-juvenile age and abnormal communication within LEC-HP-PFC networks throughout development. These functional and behavioral deficits relate to sparser projections from LEC to CA1 and decreased efficiency of axonal terminals to activate the hippocampal circuits in neonatal GE mice. In contrast, the direct entorhinal drive to PFC is not affected, yet the PFC is indirectly compromised, as target of the under-activated HP. Thus, the entorhinal-hippocampal circuit is already impaired from neonatal age on in GE mice.

Smart substation network quality monitoring and fault prediction

The smart substation communication network is the basis for information sharing of various devices in the substation. Its operation status has an important impact on the safe operation of the substation and even the power grid. Therefore, real-time status monitoring of the smart substation communication network is becoming more and more important. Aiming at the problems of single dimension, insufficient real-time performance and manual fault analysis in existing substation communication network state monitoring technology, this paper proposes a method of smart substation communication network state monitoring and fault prediction based on network communication quality. This paper uses switch ACL technology and coloring technology to obtain communication quality indexes such as bandwidth utilization, delay, and packet loss rate in real time; based on a multi-dimensional evaluation algorithm, a comprehensive evaluation model of network communication quality is constructed; the model of the relationship between abnormal network communication quality and failures is established. Finally, real-time monitoring of network communication quality and fault prediction are realized. The application analysis in a typical 110 kV substation shows that this method can effectively evaluate the network communication quality and accurately predict failures, and can guide operationer and maintenaner to quickly restore the normal operation of the communication network.

Frequency of Success in Surgery of Vesicovaginal Fistula by Layered Closure with Graft Repair

Introduction: Vesicovaginal fistulae is abnormal communication between bladder and vagina that cause continous dribling of urine. It is physically, mentally and socially distressing condition. There are various approaches for surgeries of these urogenital fistulae with different success-rate that depend upon the experience of surgeon and surgical procedures. This study can help us to estimate the success rate of layered repair with graft in vaginal route to make stragedy to adopted in severe patient. Objective: To determine frequency of success in surgery on vesic-ovaginal fistulae by layered closured with graft repair procedures among patients admitted in Isra University. Setting: Obstetrics & Gynecology department in Isra university hospital Duration: 6 months from 10.2.2014 to 10.8.2014 Study Design: Case series Subject and methods: A total of 100 patients after having surgery for vesicovaginal fistula by layered closure with graft repair was included in this study. History and examination of all subjects were taken. The follow up visit was planned after 3 weeks of surgery. All women was questioned for recurrence of continuous urinary leakage and that without such symptoms proved by absence of leakage on methylene blue dye test was labeled as ‘success’. Results: - Frequency of success in surgery on vesic-ovaginal fistulae by layered closured with graft repair procedures was observed in 88% cases. Conclusion: The success rate of VVF repair by layered closured with graft repair procedures is high. It is concluded that obstetric urogenital fistula is a preventable condition. Keywords: Vesicovaginal fistulae, Layered closured, Graft repair, urogenital fistula

A novel top‐k key node query problem in subgraph matching and its greedy strategy

AbstractTop‐k node selection in graph data is an essential problem in computer science and applications. In view of an important issue in the field of graph data, subgraph matching issue, we define the problem and propose its method for the top‐k key node query w.r.t. the subgraph matching. Unlike the general top‐k query problem, we aim to find out k nodes that make the matching subgraphs in data graph G that are covered by the k nodes as more as possible. This is a problem of the maximum coverage of subgraph matching, which belongs to the NP‐hard problem. We study the problem based on a greedy algorithm and give an intuitive solution. Considering the characteristics of the top‐k problem, we propose an improved and more efficient greedy algorithm. Experiments on real social network graph data set (Twitter) show that the related results represent the key nodes that can better reveal the essential characteristics of the query graph in the data graph G. The key node query problem in subgraph matching proposed in this article may have extensive applications in reality, such as the assessment of the influence of specific group members in social network, the detection of abnormal communication in a computer communication network, the road traffic evaluation and load balance problem in a road traffic network, and so on.

EP.TU.542Enterolith ileus secondary to small bowel diverticulum: a rare cause of small bowel obstruction

Abstract Small intestinal diverticula are rare and possibly acquired secondary to bowel dyskinesia, abnormal peristalsis or high intraluminal pressures. Enterolith formation within these diverticula and intra-luminal bowel obstruction from them are a less encountered complication. A seventy-five year old man, with no history of abdominal surgery, presented with 10 days of colicky right iliac fossa pain and recurrent episodes of bilious vomiting. He initially reported diarrhoea but complained of eventual absolute constipation for last 5 days. Physical examination revealed distended abdomen with right-sided tenderness and no mass or faeces were noted on rectal examination. Biochemistry indicated raised inflammatory markers and an acute kidney injury. Abdominal CT scan revealed a 3.5 cm calculus in the distal ileum causing obstruction initially flagged as gallstone ileus. No gallstones or pneumobilia were identified although some intrahepatic duct dilatation was noted. An emergency laparotomy was conducted, where the radiological findings were reinforced and the calculus was extracted via enterotomy. There were no abnormal communications between gallbladder and intestinal tract suggestive of passage of gallstone to ileum. The small bowel traced from duodenojejunal flexure to terminal ileum did not reveal any further calculi or diverticula. FTIR spectrum analysis of the extracted specimen indicated similarities to enterolith. Retrospective analysis of radiological images revealed a possible duodenal diverticulum. The case highlights the diagnostic conundrum and therapeutic challenges of small bowel diverticular enterolith.

Endovascular Management of Intracranial Dural AVFs: Principles.

Intracranial dural AVFs are abnormal communications between arteries that supply the dura mater and draining cortical veins or venous sinuses. They are believed to form as a response to venous insults such as thrombosis, trauma, or infection. Classification and management are dependent on the presence of drainage/reflux into cortical veins because such drainage markedly elevates the risk of hemorrhage or venous congestion, resulting in neurologic deficits. AVFs with tolerable symptoms and benign drainage patterns can be managed conservatively. Intolerable symptoms, presentation with hemorrhage/neurologic deficits, or aggressive drainage patterns are indications for intervention. Treatment options include microsurgical disconnection, endovascular transarterial embolization, transvenous embolization, or a combination. This is the first in a series of 3 articles on endovascular management of intracranial dural AVFs, in which we outline the principles and outcomes of endovascular treatment.