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Fulltext Ophthalmic artery occlusion following neuro-embolization of the external carotid artery, a case report

Loon NW, Gendeh BS, Zakaria R, Hamzah JC, Din NM

BMC Ophthalmol, 2017 Jun 15;17(1):92.
PMID: 28619056 DOI: 10.1186/s12886-017-0490-7

BACKGROUND: Embozene® is a new neuroembolizing microsphere used to reduce intraoperative bleeding for head and neck tumours. We report a case of iatrogenic ophthalmic artery occlusion after Embozene® embolization of the external carotid artery (ECA).
CASE PRESENTATION: A 22-year-old African gentleman presented with left nasal obstruction and epistaxis for 2 years and was diagnosed with nasopharyngeal carcinoma. He subsequently underwent embolization of the maxillary branch of the left ECA using Embozene® Microspheres - 250 μm in size before endoscopic tumour excision to reduce intra-operative bleeding. He complained of sudden painless profound visual loss in the left eye (LE) two hours after embolization. Visual acuity in LE was no light perception. Fundus examination showed pale retina with no cherry red spot. Arterial narrowing and segmentation were seen in all quadrants. A diagnosis of left ophthalmic artery occlusion was made. Despite immediate management including ocular massage and lowering of intraocular pressure, the visual loss remained. Retrospective review of digital subtraction angiogram showed an anastomosis between the left ophthalmic artery and anterior deep temporal artery as a potential route for microspheres migration.
CONCLUSION: Pre-operative angio-architecture understanding and diligent selection of embolic material are helpful in preventing this adverse event. The use of newer agents for embolotherapy may cause migration of embolic material from the external to the internal carotid system leading to ophthalmic artery occlusion and blindness.

Matched MeSH terms: Nasopharyngeal Neoplasms/blood supply
Fulltext Ocular Blood Flow in Rabbits under Deep Anesthesia: A Real-Time Measurement Technique and Its Application in Characterizing Retinal Ischemia

Bhatti MS, Tang TB, Chen HC

Sci Rep, 2018 04 09;8(1):5713.
PMID: 29632320 DOI: 10.1038/s41598-018-24141-4

In this study, we reported a new technique based on laser speckle flowgraphy to record the ocular blood flow in rabbits under deep anesthesia, and proposed parameters to characterize retinal ischemia. We applied the proposed technique to study the correlation of blood flow between the eyes of normal non-anesthetized animals, and to characterize the occlusion of the internal carotid artery (ICA) and external carotid artery (ECA). We established a correlation in blood flow between the eyes of non-anesthetized animals, and derived two new parameters, namely, the laterality index and vascular perfusion estimate (VPE). Our experimental results from 16 eyes (of 13 New Zealand white rabbits) showed a reduction in ocular blood flow with a significant decrease in the VPE after the occlusion of the ECA (p blood flow was observed with the occlusion of the ICA. In conclusion, we demonstrated a means for the real-time measurement of the ocular blood flow in rabbits under deep anesthesia by using laser speckle flowgraphy and the VPE as an indicator of successful occlusion. The proposed technique might be applicable in quantifying the efficacy of new drugs and interventions for the treatment of retinal ischemia.

Matched MeSH terms: Eye/blood supply*
Real-Time Remote Health Monitoring Systems Using Body Sensor Information and Finger Vein Biometric Verification: A Multi-Layer Systematic Review

Mohsin AH, Zaidan AA, Zaidan BB, Albahri AS, Albahri OS, Alsalem MA, et al.

J Med Syst, 2018 Oct 16;42(12):238.
PMID: 30327939 DOI: 10.1007/s10916-018-1104-5

The development of wireless body area sensor networks is imperative for modern telemedicine. However, attackers and cybercriminals are gradually becoming aware in attacking telemedicine systems, and the black market value of protected health information has the highest price nowadays. Security remains a formidable challenge to be resolved. Intelligent home environments make up one of the major application areas of pervasive computing. Security and privacy are the two most important issues in the remote monitoring and control of intelligent home environments for clients and servers in telemedicine architecture. The personal authentication approach that uses the finger vein pattern is a newly investigated biometric technique. This type of biometric has many advantages over other types (explained in detail later on) and is suitable for different human categories and ages. This study aims to establish a secure verification method for real-time monitoring systems to be used for the authentication of patients and other members who are working in telemedicine systems. The process begins with the sensor based on Tiers 1 and 2 (client side) in the telemedicine architecture and ends with patient verification in Tier 3 (server side) via finger vein biometric technology to ensure patient security on both sides. Multilayer taxonomy is conducted in this research to attain the study's goal. In the first layer, real-time remote monitoring studies based on the sensor technology used in telemedicine applications are reviewed and analysed to provide researchers a clear vision of security and privacy based on sensors in telemedicine. An extensive search is conducted to identify articles that deal with security and privacy issues, related applications are reviewed comprehensively and a coherent taxonomy of these articles is established. ScienceDirect, IEEE Xplore and Web of Science databases are checked for articles on mHealth in telemedicine based on sensors. A total of 3064 papers are collected from 2007 to 2017. The retrieved articles are filtered according to the security and privacy of telemedicine applications based on sensors. Nineteen articles are selected and classified into two categories. The first category, which accounts for 57.89% (n = 11/19), includes surveys on telemedicine articles and their applications. The second category, accounting for 42.1% (n = 8/19), includes articles on the three-tiered architecture of telemedicine. The collected studies reveal the essential need to construct another taxonomy layer and review studies on finger vein biometric verification systems. This map-matching for both taxonomies is developed for this study to go deeply into the sensor field and determine novel risks and benefits for patient security and privacy on client and server sides in telemedicine applications. In the second layer of our taxonomy, the literature on finger vein biometric verification systems is analysed and reviewed. In this layer, we obtain a final set of 65 articles classified into four categories. In the first category, 80% (n = 52/65) of the articles focus on development and design. In the second category, 12.30% (n = 8/65) includes evaluation and comparative articles. These articles are not intensively included in our literature analysis. In the third category, 4.61% (n = 3/65) includes articles about analytical studies. In the fourth category, 3.07% (n = 2/65) comprises reviews and surveys. This study aims to provide researchers with an up-to-date overview of studies that have been conducted on (user/patient) authentication to enhance the security level in telemedicine or any information system. In the current study, taxonomy is presented by explaining previous studies. Moreover, this review highlights the motivations, challenges and recommendations related to finger vein biometric verification systems and determines the gaps in this research direction (protection of finger vein templates in real time), which represent a new research direction in this area.

Matched MeSH terms: Fingers/blood supply*
A rare presentation of chronic myeloid leukaemia with priapism treated with corporoglandular shunting

Huei TJ, Lip HT, Shamsuddin O

Med J Malaysia, 2018 12;73(6):420-422.
PMID: 30647220

Priapism is a rare clinical presentation of a patient with chronic myeloid leukaemia (CML). Herein, we present a young Nepalese man that presented to the emergency department with an acute and painful penile erection for two days. Clinically, he was pale and abdominal examination revealed hepatomegaly. Combined oncologic and initial urological intervention with carvernosal aspiration and intracavernosal phenylephrine failed to achieve detumescence. The patient underwent an emergency corporoglandular shunting eventually. In this case report, we discuss the management compared with previously reported cases.

Matched MeSH terms: Penis/blood supply
Based Medical Systems for Patient's Authentication: Towards a New Verification Secure Framework Using CIA Standard

Mohsin AH, Zaidan AA, Zaidan BB, Albahri OS, Albahri AS, Alsalem MA, et al.

J Med Syst, 2019 May 22;43(7):192.
PMID: 31115768 DOI: 10.1007/s10916-019-1264-y

In medical systems for patient's authentication, keeping biometric data secure is a general problem. Many studies have presented various ways of protecting biometric data especially finger vein biometric data. Thus, It is needs to find better ways of securing this data by applying the three principles of information security aforementioned, and creating a robust verification system with high levels of reliability, privacy and security. Moreover, it is very difficult to replace biometric information and any leakage of biometrics information leads to earnest risks for example replay attacks using the robbed biometric data. In this paper presented criticism and analysis to all attempts as revealed in the literature review and discussion the proposes a novel verification secure framework based confidentiality, integrity and availability (CIA) standard in triplex blockchain-particle swarm optimization (PSO)-advanced encryption standard (AES) techniques for medical systems patient's authentication. Three stages are performed on discussion. Firstly, proposes a new hybrid model pattern in order to increase the randomization based on radio frequency identification (RFID) and finger vein biometrics. To achieve this, proposed a new merge algorithm to combine the RFID features and finger vein features in one hybrid and random pattern. Secondly, how the propose verification secure framework are followed the CIA standard for telemedicine authentication by combination of AES encryption technique, blockchain and PSO in steganography technique based on proposed pattern model. Finally, discussed the validation and evaluation of the proposed verification secure framework.

Matched MeSH terms: Fingers/blood supply
Spontaneous massive haemothorax in the peri-partum period of an undiagnosed neurofibromatosis type 1 patient - A surgical perspective

Narasimman S, Govindasamy H, Seevalingam KK, Paramasvaran G, Ramasamy U

Med J Malaysia, 2019 02;74(1):99-101.
PMID: 30846675

Acute massive haemothorax is a life-threatening situation, which is often associated with a preceding trauma. However, spontaneous haemothorax is a rare occurrence, especially in pregnancy. Spontaneous haemothorax in the immediate post-partum period secondary to a ruptured intercostal AVM is extremely rare more so in the background of an undiagnosed neurofibromatosis. This is a report of a young lady presenting with pleuritis and breathlessness after the delivery of her 1st child. Her management is discussed.

Matched MeSH terms: Intercostal Muscles/blood supply
Fulltext Longitudinal effects of common carotid artery stenosis on ocular hemodynamics assessed using laser speckle flowgraphy in a rabbit model

Ismail A, Chen HC, Faye I, Tang TB

Sci Rep, 2020 09 28;10(1):15829.
PMID: 32985560 DOI: 10.1038/s41598-020-72556-9

Real-time impairment of ocular blood flow (OBF) under common carotid artery stenosis (CCAS) has not been ascertained. We aimed to longitudinally assess the impact of CCAS on OBF using a rabbit model. About 75% stenosis was created by tying the common carotid artery with a plastic mandrel using a nylon suture. The plastic mandrel was gently removed, leaving a ligature. Neurological and behavioral assessments were recorded as the clinical indicator of stroke severity. With laser speckle flowgraphy, the pulse waveform parameters namely mean blur rate (MBR), blowout score (BOS), blowout time (BOT), rising rate, S1-area, falling rate (FR), S2-area, flow acceleration index (FAI), acceleration time index, resistive index (RI) and the difference between the maximum and minimum values of MBR (AC) were assessed in overall, vessel, and tissue regions of the optic nerve head (ONH). Longitudinally, BOS significantly increased until day 19 post-surgery, whereas FAI, RI, and AC significantly decreased. Beyond day 19, BOS, BOT, FR, FAI, RI, and AC significantly decreased. We defined two stages representing impaired vessel conditions, namely the vessel resistance phase, where BOS increases and FAI, RI, and AC decrease, and the vessel elasticity phase where BOS, BOT, FR, FAI, RI and AC decrease. These stages provide information about atherosclerosis, assessable non-invasively through the eye.

Matched MeSH terms: Eye/blood supply*
Skin wound healing assisted by angiogenic targeted tissue engineering: A comprehensive review of bioengineered approaches

Nour S, Imani R, Chaudhry GR, Sharifi AM

J Biomed Mater Res A, 2021 04;109(4):453-478.
PMID: 32985051 DOI: 10.1002/jbm.a.37105

Skin injuries and in particular, chronic wounds, are one of the major prevalent medical problems, worldwide. Due to the pivotal role of angiogenesis in tissue regeneration, impaired angiogenesis can cause several complications during the wound healing process and skin regeneration. Therefore, induction or promotion of angiogenesis can be considered as a promising approach to accelerate wound healing. This article presents a comprehensive overview of current and emerging angiogenesis induction methods applied in several studies for skin regeneration, which are classified into the cell, growth factor, scaffold, and biological/chemical compound-based strategies. In addition, the advantages and disadvantages of these angiogenic strategies along with related research examples are discussed in order to demonstrate their potential in the treatment of wounds.

Matched MeSH terms: Skin/blood supply*
Fulltext Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review

Md Lazin Md Lazim MR, Aminuddin A, Chellappan K, Ugusman A, Hamid AA, Wan Ahmad WAN, et al.

Int J Environ Res Public Health, 2020 04 10;17(7).
PMID: 32290168 DOI: 10.3390/ijerph17072591

Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers.

Matched MeSH terms: Fingers/blood supply*
Epidemiology of surgically treated patient in road traffic accident with lower extremity vascular injury from a single centre in Kelantan

Koh SC, Wan Faisham Nu'man WI, Siti Fatimah NMJ, Wan Azman WS, Mohammad P, Arman Zaharil MS

Med J Malaysia, 2020 05;75(3):292-294.
PMID: 32467547

INTRODUCTION: Lower extremity vascular injury can result in either temporary or permanent disability.
METHODS: This is a clinical audit involving all patients admitted to our institution from January 2008 to June 2018 of those who had undergone revascularization surgery for lower limb trauma.
RESULTS: Fifty-nine patients were in this study with a mean age of 28.1 years. Most of the patients were motorcyclist involved in road traffic accidents with cars (n=30, 50.8%). The popliteal artery was most commonly seen injury (n=41, 69.5%). The mean duration of ischaemia was 14.1 hours. The limb salvage rate was 89.8%.
CONCLUSION: Lower extremity vascular injury caused by RTA treated in our institution predominantly involved young patients aged between 18-30 years associated with long bone fractures causing contusion and thrombosis of the popliteal artery.

Matched MeSH terms: Lower Extremity/blood supply*
Primary torsion of the greater omentum

Gul YA, Jabbar MF, Moissinac K

Acta Chir. Belg., 2001 Nov-Dec;101(6):312-4.
PMID: 11868511

Primary or idiopathic greater omental torsion remains a rare cause of acute surgical abdomen in adults and children. The aetiology is as yet unknown and the treatment of choice, once diagnosis is established, is resection of the torted omentum. We report our experience with three such cases encountered over the last five years, two of which were diagnosed and subsequently managed laparoscopically. The performance of diagnostic laparoscopy for acute abdominal pain of an undetermined origin may lead to an increased detection of this condition and subsequent therapeutic intervention.

Matched MeSH terms: Omentum/blood supply*
Fulltext Case of a non-pulsatile groin swelling

Razif MA, Rajasingam V, Abdullah BJJ

Med J Malaysia, 2002 Dec;57(4):499-502.
PMID: 12733179

We report a case of a non-pulsatile groin swelling in a 38 years old male drug addict without the typical clinical signs of an aneurysm. Ultrasound revealed a left femoral artery pseudo-aneurysm. He was surgically treated and the vessels were ligated without revascularisation.

Matched MeSH terms: Groin/blood supply
Fulltext Revascularization for foot salvage in diabetic critical foot ischaemia

Yii MK, Liew NC

Med J Malaysia, 1999 Sep;54(3):325-8.
PMID: 11045058

A consecutive series of 32 diabetic patients, 16 male and 16 female, who presented to the authors with critical limb ischaemia was reviewed over a two-year period. Atherosclerotic risk factors and co-morbidities were present in 56% of these patients. Diagnostic angiography was performed in all patients. Revascularization was achieved in 91% of the cases with three perioperative deaths. Ten bypasses were anastomosed distally to one of the crural or ankle arteries at the foot. Major amputations were required in five patients who had had revascularization and in 4 of these gross sepsis was the main factor responsible for limb loss despite patent grafts. The primary graft patency rates at one month and one year were 96% and 90% respectively. Surgical reconstruction was possible in the majority of diabetic patients with critical ischaemia and should be offered to patients preferably before the establishment of gross sepsis to improve limb salvage.

Matched MeSH terms: Foot/blood supply*
Fulltext Unilateral superior ophthalmic vein thrombosis in a user of oral contraceptives

Jaais F, Habib ZA

Med J Malaysia, 1994 Dec;49(4):416-8.
PMID: 7674980

A patient on oral contraceptives over several years developed unilateral proptosis, haemorrhagic retinopathy and increase in intraocular pressure. An orbital vein venogram confirmed the diagnosis of right superior ophthalmic vein thrombosis. There was complete resolution of thrombosis and eye signs and symptoms with discontinuation of the oral contraceptive.

Matched MeSH terms: Orbit/blood supply*
Fulltext Hand replantation and revascularization--six years experience in Hospital Kuala Lumpur 1990-1995

Razana A, Hyzan MY, Pathmanathan V, Gill RS

Med J Malaysia, 1998 Sep;53 Suppl A:121-30.
PMID: 10968194

A retrospective study was conducted in 130 patients who underwent replantation or revascularization of 195 amputations in Hand and Microsurgery Unit Hospital Kuala Lumpur from 1990 to 1995. There were 130 patients with 195 amputations in the duration of 6 years study, which were mainly males (111 patients, 85.4%). The commonest age group involved was 19-25 years old (49 cases, 63.7%). There were 146 complete amputations replanted and 49 cases of incomplete amputations were revascularized. The commonest part involved was thumb and index finger (23% of cases each) and majority was caused by industrial accident (60.8%). However in pediatric age group home accident was the leading cause of the amputation (93.8%). The overall survival rate for the amputation was 65.6%. Revascularization had a better survival rate (77.6%) than replantation (61.6%). A clean cut wound and ischaemic time less than 12 hours gave better survival rate. However, there was no significant different chance of survival on distribution of injured parts and ischaemic time (< 12 hours).

Matched MeSH terms: Hand/blood supply*
Fulltext Spontaneous intra-partum rupture of uterine vein--an uncommon cause of intra-abdominal haemorrhage

Kuppuvelumani P, Rachagan SP, Khin MS

Med J Malaysia, 1994 Jun;49(2):185-6.
PMID: 8090103

A rare case of spontaneous rupture of a branch of the uterine vein in a primigravida is discussed. The patient with an uncomplicated pregnancy presented with signs and symptoms suggestive of abruptio placenta with foetal distress. Lower segment Caesarean section was performed. The cause of acute pain was identified to be intra-abdominal bleeding secondary to the rupture of a branch of the uterine vein. The pathophysiology of the problem is discussed.

Matched MeSH terms: Uterus/blood supply*
Natural products against cancer angiogenesis

Khalid EB, Ayman EE, Rahman H, Abdelkarim G, Najda A

Tumour Biol., 2016 Nov;37(11):14513-14536.
PMID: 27651162

The process of angiogenesis is quite well-known nowadays. Some medicines and extracts affecting this process are already used routinely in supporting the conventional treatment of many diseases that are considered angiogenic such as cancer. However, we must be aware that the area of currently used drugs of this type is much narrower than the theoretical possibilities existing in therapeutic angiogenesis. Plant substances are a large and diverse group of compounds that are found naturally in fruits, vegetables, spices, and medicinal plants. They also have different anticancer properties. The aim of this literature review article is to present the current state of knowledge concerning the molecular targets of tumor angiogenesis and the active substances (polyphenols, alkaloids, phytohormones, carbohydrates, and terpenes) derived from natural sources, whose activity against cancer angiogenesis has been confirmed.

Matched MeSH terms: Neoplasms/blood supply*
Fulltext Skin paddle as an indicator of the viability of vascularised fibular graft

Imran Y, Zulmi W, Halim AS

Singapore Med J, 2004 Mar;45(3):110-2.
PMID: 15029411

Immediate recognition of anastomotic failure is important to ensure the viability of the vascularised fibular graft. The problems associated with post-operative bone scanning and angiography for immediate detection of anastomotic failure have been described.

Matched MeSH terms: Fibula/blood supply
Anomalous arterial supply to the muscles in a combined latissimus dorsi and serratus anterior flap

Halim AS, Wan Z

Clin Anat, 2004 May;17(4):358-9.
PMID: 15108344

The combined latissimus dorsi and serratus anterior flap has been employed for large defect reconstruction and has been shown to be reliable. These flaps are based on the subscapular-thoracodorsal vascular pedicle that usually supplies both muscles. In the case reported, serratus anterior possessed an anomalous arterial supply totally independent of the subscapular pedicle. The latissimus dorsi and serratus anterior muscles were used as a combined flap to reconstruct a massive thigh defect. The combined flap required two arterial anastomoses.

Matched MeSH terms: Surgical Flaps/blood supply*
Fulltext Uterine artery bleeding and haemoperitoneum during the second trimester in pregnancy

Achanna KS, Goh CS

Med J Malaysia, 2003 Mar;58(1):128-30.
PMID: 14556339

A case of spontaneous rupture of uterine artery in the second trimester of pregnancy is described. Haemorrhage from rupture of uterine artery during pregnancy was discovered at laparotomy. This was an unusual but serious complication of pregnancy. This condition is extremely rare and one must consider it in cases of incomprehensible abdominal pain with or without haemodynamic collapse. A review of the literature revealed only four similar cases so far. This pregnancy continued till 37 weeks pregnancy and had a spontaneous vaginal delivery. Immediate institution of effective resuscitative measures and early surgical intervention were essential to both foetal and maternal survival.

Matched MeSH terms: Uterus/blood supply*

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