Isolated aneurysmal degeneration and dissection of the iliac artery, without involving the aorta, are uncommon, with an overall incidence in the general population being as low as approximately 0.03%. Solitary iliac artery aneurysm represents approximately 0.4 to 1.9% of all cases of aneurysmal disease; with involvement of external iliac artery being the least common and extremely rare and present in only 10% of these cases. Risk factors for external iliac dissection resulting from an aneurysm, are similar to that of abdominal aorta aneurysm and include male gender, white race, advancing age, history of smoking, hypertension and known atherosclerotic disease. We present a case of a 70 year old Caucasian male, with a past medical history of well controlled hypertension, dyslipidemia and remote history of smoking, who underwent a contrast enhanced CT Abdomen and pelvis to evaluate a renal cyst. However, was found to have short segment right external iliac artery dissection without distal propagation. He reported no symptoms - denied intermittent leg pain on exertion, lumbosacral pain, lower extremity edema, weakness or numbness/tingling in his legs. Also, denied urinary or bowel complains including urinary retention, pain during defecation and constipation. He reported a 28 pack year history of smoking and had quit smoking 50 years ago. Vital signs were recorded as: blood pressure 114/68 mmHg, pulse rate 66 bpm, respiratory rate 16 breaths/min and body temperature 96.6F. On physical examination, abdomen was soft, non tender, non distended and bowel sounds were present in all four quadrants. No guarding or rigidity was noted. Peripheral pulses were well palpable and equal. Laboratory data including CBC and CMP were within normal limits. ESR and CRP were 12 and In conclusion, this is a rare case of isolated asymptomatic external iliac artery dissection, diagnosed as an incidental finding. The treatment of this condition is unclear because of its rare occurrence. Cases complicated with rupture/ symptomatic patients should be treated surgery or endovascular repair. Asymptomatic patients with smaller size of

No description available.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, cardiogenic shock, and sudden cardiac death in women of reproductive age who have no traditional risk factors for coronary artery disease. The etiology, prognosis, and treatment of SCAD remain poorly defined. Coronary angiography is the gold standard for diagnosis. Management includes medical therapy and revascularization procedures using percutaneous intervention and coronary artery bypass grafting. Possible mechanisms of SCAD include rupture of atherosclerotic plaque or vasa vasorum, hemorrhage between the outer media and external lamina with intramedial hematoma expansion, and compression of the vessel lumen. We report a case of SCAD in a 39-year-old woman presenting with ST-elevation myocardial infarction midway through her menstrual cycle. Her medications included fenfluramine for obesity and hydrochlorothiazide, amlodipine, and atenolol for hypertension.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19397号 / 医博第4048号 / 新制||医||1012(附属図書館) / 32422 / 京都大学大学院医学研究科医学専攻 / (主査)教授 渡邊 直樹, 教授 小泉 昭夫, 教授 木村 剛 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13494号 / 論医博第2259号 / 新制||医||1060(附属図書館) / (主査)教授 石見 拓, 教授 大鶴 繁, 教授 近藤 尚己 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Blunt carotid artery injury (BCAI), resulting primarily from automobile accidents, is a major contributor to the high mortality and morbidity rates associated with carotid artery dissection. More work is needed to characterize carotid artery injury mechanisms, quantify stages of damage, and elucidate failure modalities as a result of this type of injury. The present study examines the structure and mechanics of the carotid artery in the circumferential and axial directions by employing uniaxial tensile testing, high speed videography, interruption testing, scanning electron microscopy (SEM), histological analysis, real-time environmental SEM assessment, and atomic force microscopy (AFM). Results are as follows: (i) the carotid artery exhibits anisotropic, viscoelastic behavior; (ii) intimal failure precedes ultimate tissue failure, and the layers in order of increasing strength are intima, adventitia, and media; (iii) tissue damage accumulates as strain level increases, and failure occurs as a result of void nucleation, void growth, and void coalescence.

Current ACL reconstruction techniques are performed with little regard to cutaneous nerves despite the evidence that iatrogenic nerve injury often leads to painful neuromas, reflex sympathetic dystrophy, or anterior knee/kneeling pain which directly impacts patients whose profession requires kneeling (Cerulli et al. 2013; Ruffilli et al. 2016; Hurley et al. 2018). In this study, the femoral cutaneous and saphenous nerves from two embalmed lower extremities were dissected in exquisite detail to create topographic maps of the anterior thigh and knee, detailing the nerves' anatomical course and relationship to relevant landmarks. To further characterize the cutaneous innervation at the knee joint, ultrasound techniques to locate sensory nerves were also explored. In both specimens, all branches of the femoral cutaneous and saphenous nerves were located, dissected, and mapped. In addition, the ability to locate terminal branches of the anterior femoral cutaneous nerve in a cadaveric specimen on ultrasound was successfully demonstrated. However, due to the small sample size, further research implementing similar methods is necessary to ensure the results are representative of the population and can be applied to surgical innervation. These findings highlight the importance of considering cutaneous nerves in ACL reconstruction techniques to minimize the risk of iatrogenic nerve injury and associated complications.

No description available.

No description available.

In order to initiate a genetic dissection of the Drosophila melanogaster larval response to light, two new single larva assays were designed: the Checker and ON/OFF assays. Each assay allows quantification of different aspects of the larval visual response by permitting the study of discrete behaviours in a single larva. Results of this study indicate that larvae respond to light by modulating their locomotion. In the Checker assay this can be seen as an increase in residence time spent in dark checks. In the ON/OFF assay this can be measured as a decrease in distance travelled during the light pulse, due at least in part to an increase in head swinging. Concomitantly, the larva exhibits a sharp change in direction from its original path when the lights are turned on. When the lights are turned off, the change in direction in the larval path, although smaller than at lights on, is still greater than in the absence of light transitions. Many of the components previously described to function in adult phototransduction and visual system specification, also have roles in the larval photoresponse as mutations in the genes that encode these components, are able to abolish light perception as measured in both the Checker and ON/OFF assays. However, these mutations disrupt only subsets of the behaviours associated with the larval perception of light, thus suggesting the existence of light detecting mechanism independent of the main visual pathway described for the adult visual system. / Thesis / Master of Science (MS)