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Ferrari J.P.,Northeastern Ohio Universities Colleges of Medicine | Hemphill A.F.,Summa Health System | Xu J.,Hahnemann University | Dejesus R.A.,Johns Hopkins
Annals of Plastic Surgery | Year: 2013

Vaginal reconstructive options commonly include the use of split-thickness skin grafts or intestinal conduits. When a colonic segment is chosen, the sigmoid colon is favored because of its location, size, and durability. When circumstances preclude the use of sigmoid colon and a colonic conduit is preferred, creative means of mobilization are required. This article describes a case and technique utilizing the descending colon in a tension-free vaginoplasty. Copyright © 2012 by Lippincott Williams & Wilkins. Source


Borbouse L.,Indiana University | Dick G.M.,West Virginia University | Payne G.A.,Indiana University | Payne B.D.,Indiana University | And 6 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2010

This investigation was designed to examine the hypothesis that impaired function of coronary microvascular large-conductance Ca2+-activated K+ (BKCa) channels in metabolic syndrome (MetS) significantly attenuates the balance between myocardial oxygen delivery and metabolism at rest and during exercise-induced increases in myocardial oxygen consumption (MV̇O2). Studies were conducted in conscious, chronically instrumented Ossabaw swine fed a normal maintenance diet (11% kcal from fat) or an excess calorie atherogenic diet (43% kcal from fat, 2% cholesterol, 20% kcal from fructose) that induces many common features of MetS. Data were collected under baseline/resting conditions and during graded treadmill exercise before and after selective blockade of BKCa channels with penitrem A (10 μg/kg iv). We found that the exercise-induced increases in blood pressure were significantly elevated in MetS swine. No differences in baseline cardiac function or heart rate were noted. Induction of MetS produced a parallel downward shift in the relationship between coronary venous PO2 and MV̇O2 (P < 0.001) that was accompanied by a marked release of lactate (negative lactate uptake) as MV̇O2 was increased with exercise (P < 0.005). Inhibition of BKCa channels with penitrem A did not significantly affect blood pressure, heart rate, or the relationship between coronary venous PO2 and MV̇O2 in lean or MetS swine. These data indicate that BKCa channels are not required for local metabolic control of coronary blood flow under physiological (lean) or pathophysiological (MetS) conditions. Therefore, diminished function of BKCa channels does not contribute to the impairment of myocardial oxygen-supply demand balance in MetS. Copyright © 2010 American Physiological Society. Source


Patel N.P.,Northeastern Ohio Universities Colleges of Medicine and Pharmacy | Tantri M.D.P.,Northeastern Ohio Universities Colleges of Medicine
Cleft Palate-Craniofacial Journal | Year: 2010

Median cleft lip is a midline vertical cleft through the upper lip. This is a rare anomaly with very few cases described in the literature. Median cleft lip has been thought to be associated with hypertelorism or hypotelorism. It is caused by the failure of fusion of the medial nasal prominences. In this case report, a 4 1/2-year-old girl with a median cleft is presented. The patient has no other anomalies of the nose or alveolus. The patient has normotelorism. A shortened bifid frenulum of the upper lip is present. A technique using an elliptical excision of the cleft with muscle approximation is described. Source


Borbouse L.,Indiana University | Dick G.M.,West Virginia University | Payne G.A.,Indiana University | Berwick Z.C.,Indiana University | And 5 more authors.
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2010

This investigation tested the hypothesis that metabolic syndrome decreases the relative contribution of specific K+ channels to coronary reactive hyperemia. Ca2+-activated (BKCa), voltage-activated (KV), and ATP-dependent (KATP) K + channels were investigated. Studies were conducted in anesthetized miniature Ossabaw swine fed a normal maintenance diet (11% kcal from fat) or an excess calorie atherogenic diet (43% kcal from fat, 2% cholesterol, 20% kcal from fructose) for 20 wk. The latter diet induces metabolic syndrome, increasing body weight, fasting glucose, total cholesterol, and triglyceride levels. Ischemic vasodilation was determined by the coronary flow response to a 15-s occlusion before and after cumulative administration of antagonists for BK Ca (penitrem A; 10 μg/kg iv), KV (4-aminopyridine; 0.3 mg/kg iv) and KATP (glibenclamide; 1 mg/kg iv) channels. Coronary reactive hyperemia was diminished by metabolic syndrome as the repayment of flow debt was reduced ∼30% compared with lean swine. Inhibition of BK Ca channels had no effect on reactive hyperemia in either lean or metabolic syndrome swine. Subsequent inhibition of KV channels significantly reduced the repayment of flow debt (∼25%) in both lean and metabolic syndrome swine. Additional blockade of KATP channels further diminished (∼45%) the repayment of flow debt in lean but not metabolic syndrome swine. These data indicate that the metabolic syndrome impairs coronary vasodilation in response to cardiac ischemia via reductions in the contribution of K+ channels to reactive hyperemia. Copyright © 2010 the American Physiological Society. Source


Syed M.I.,Dayton Interventional Radiology | Syed M.I.,Wright State University | Yu B.,Northwestern University | Akhter T.,Northeastern Ohio Universities Colleges of Medicine | Shaikh A.,Dayton Interventional Radiology
Perspectives in Vascular Surgery and Endovascular Therapy | Year: 2011

An adult male with nutcracker syndrome was treated successfully by placement of a self-expanding stent in the left renal vein via a right internal jugular vein approach with a provocative Valsalva maneuver. Previous case reports have described renal vein stenting for this condition via common femoral vein approach. However, this study proposes the right internal jugular vein approach as a safer method for the treatment of nutcracker syndrome since the stent can be easily captured along the guidewire if undersized. This technique is based on the realization that the left renal vein diameter may increase by 50% to 58% during the Valsalva maneuver. © The Author(s) 2011. Source

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