Choroid Plexus Hyperplasia with Intractable Ascites and a Resulting Communicating Hydrocele following Shunt Operation for Hydrocephalus

2018 ◽  
Vol 53 (6) ◽  
pp. 407-412 ◽  
Author(s):  
Yusuke S. Hori ◽  
Keina Nagakita ◽  
Yuki Ebisudani ◽  
Mizuho Aoi ◽  
Yoko Shinno ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Shunt Operation ◽  
Intractable Ascites

RANDOMIZED TRIAL OF ANTITHROMBIN III VERSUS PLACEBO IN PATIENTS UNDERGOING PERITONEO-VENOUS SHUNT OPERATION

1987 ◽  
Author(s):  
C Korninger ◽  
W Klepetko ◽  
J Miholic ◽  
Ch Schwarz ◽  
K Lechner
Keyword(s):  
Randomized Trial ◽  
Antithrombin Iii ◽  
Coagulation Factor ◽  
Shunt Operation ◽  
Alcoholic Liver Cirrhosis ◽  
Intractable Ascites ◽  
Venous Shunt ◽  
At Iii ◽  
Fibrin Monomers ◽  
Gelation Test

A randomized trial of Antithrombin III (AT III) versus placebo was performed in patients undergoing peritoneo-venous shunt operation because of intractable ascites. 10 patients with alcoholic liver cirrhosis (Child's stages B and C) were enrolled. Randomization was performed according to the stage of liver disease and to preoperative AT III levels. AT III concentrate (kindly provided by Kabi) was infused in 5 patients, twice daily for 4 days, at a dose of 20 U/kg BW, starting 12 hours prior to operation. Coagulation studies were performed preoperatively, and on postoperative days 1, 3 and 7.In all patients, ethanol gelation test was positive on postoperative days 1 and 3, indicating the presence of fibrin monomers. No difference between the two groups was seen with respect to prothrombin times, coagulation factor levels, FPA concentrations or fibrinolysis parameters. It is concluded that the severity of disseminated intravascular coagulation can be tempered by AT III substitution, but, with the administered dosage, DIC cannot be prevented.

Organization of tight junctions in the choroid plexus epithelium

1978 ◽  
Vol 36 (2) ◽  
pp. 336-337
Author(s):  
B. Van Deurs ◽  
J. K. Koehler
Keyword(s):  
Choroid Plexus ◽  
Present Report ◽  
Freeze Fracture ◽  
Barrier Properties ◽  
Cell Junctions ◽  
Structural Basis ◽  
Apical Surface ◽  
Choroid Plexus Epithelium ◽  
Solid Nitrogen ◽  
Special Composition

The choroid plexus epithelium constitutes a blood-cerebrospinal fluid (CSF) barrier, and is involved in regulation of the special composition of the CSF. The epithelium is provided with an ouabain-sensitive Na/K-pump located at the apical surface, actively pumping ions into the CSF. The choroid plexus epithelium has been described as “leaky” with a low transepithelial resistance, and a passive transepithelial flux following a paracellular route (intercellular spaces and cell junctions) also takes place. The present report describes the structural basis for these “barrier” properties of the choroid plexus epithelium as revealed by freeze fracture.Choroid plexus from the lateral, third and fourth ventricles of rats were used. The tissue was fixed in glutaraldehyde and stored in 30% glycerol. Freezing was performed either in liquid nitrogen-cooled Freon 22, or directly in a mixture of liquid and solid nitrogen prepared in a special vacuum chamber. The latter method was always used, and considered necessary, when preparations of complementary (double) replicas were made.

MR Findings of Choroid Plexus Papilloma: Case Report

1994 ◽  
Vol 30 (4) ◽  
pp. 643
Author(s):  
Joo Hyeong Oh ◽  
Tae Hoon Kim ◽  
Woo Suk Choi
Keyword(s):  
Case Report ◽  
Choroid Plexus ◽  
Choroid Plexus Papilloma ◽  
Plexus Papilloma

Outcomes of the Extracardiac Fontan Procedure Using Cardiopulmonary Bypass: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 173 ◽  
Author(s):  
Murat Ugurlucan ◽  
Eylem Yayla Tuncer ◽  
Fusun Guzelmeric ◽  
Eylul Kafali ◽  
Omer Ali Sayin ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Arterial Oxygen Saturation ◽  
Vena Cava ◽  
Arterial Oxygen ◽  
Shunt Operation ◽  
Early Results ◽  
The Mean ◽  
Extracardiac Fontan

<p><strong>Background</strong>: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.</p><p><strong>Methods</strong>: Between September 2011 and April 2013,  9 consecutive patients (3 males and 6 females) underwent extra-cardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon.  The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the infe-rior vena cava and right pulmonary artery.</p><p><strong>Results</strong>: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged with-out complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventila-tion within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ±  1.9 days, respectively.</p><p><strong>Conclusions</strong>: The extracardiac Fontan operation per-formed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favor-able postoperative hemodynamics and morbidity rates.</p>

Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection

2020 ◽  
Vol 133 (2) ◽  
pp. 521-529 ◽  
Author(s):  
Vivek P. Bodani ◽  
Gerben E. Breimer ◽  
Faizal A. Haji ◽  
Thomas Looi ◽  
James M. Drake
Keyword(s):  
Choroid Plexus ◽  
Computer Aided Design ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Comfort Level ◽  
Complex Case ◽  
Patient Specific ◽  
Surgical Simulator ◽  
Perceived Realism ◽  
Noncontrast Ct

OBJECTIVEEndoscopic resection of third-ventricle colloid cysts is technically challenging due to the limited dexterity and visualization provided by neuroendoscopic instruments. Extensive training and experience are required to master the learning curve. To improve the education of neurosurgical trainees in this procedure, a synthetic surgical simulator was developed and its realism, procedural content, and utility as a training instrument were evaluated.METHODSThe simulator was developed based on the neuroimaging (axial noncontrast CT and T1-weighted gadolinium-enhanced MRI) of an 8-year-old patient with a colloid cyst and hydrocephalus. Image segmentation, computer-aided design, rapid prototyping (3D printing), and silicone molding techniques were used to produce models of the skull, brain, ventricles, and colloid cyst. The cyst was filled with a viscous fluid and secured to the roof of the third ventricle. The choroid plexus and intraventricular veins were also included. Twenty-four neurosurgical trainees performed a simulated colloid cyst resection using a 30° angled endoscope, neuroendoscopic instruments, and image guidance. Using a 19-item feedback survey (5-point Likert scales), participants evaluated the simulator across 5 domains: anatomy, instrument handling, procedural content, perceived realism, and confidence and comfort level.RESULTSParticipants found the simulator’s anatomy to be highly realistic (mean 4.34 ± 0.63 [SD]) and appreciated the use of actual instruments (mean 4.38 ± 0.58). The procedural content was also rated highly (mean 4.28 ± 0.77); however, the perceived realism was rated slightly lower (mean 4.08 ± 0.63). Participants reported greater confidence in their ability to perform an endoscopic colloid cyst resection after using the simulator (mean 4.45 ± 0.68). Twenty-three participants (95.8%) indicated that they would use the simulator for additional training. Recommendations were made to develop complex case scenarios for experienced trainees (normal-sized ventricles, choroid plexus adherent to cyst wall, bleeding scenarios) and incorporate advanced instrumentation such as side-cutting aspiration devices.CONCLUSIONSA patient-specific synthetic surgical simulator for training residents and fellows in endoscopic colloid cyst resection was successfully developed. The simulator’s anatomy, instrument handling, and procedural content were found to be realistic. The simulator may serve as a valuable educational tool to learn the critical steps of endoscopic colloid cyst resection, develop a detailed understanding of intraventricular anatomy, and gain proficiency with bimanual neuroendoscopic techniques.

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