[Compensation for diagnostic errors].
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Biomedical subjects
Publications and source records attributed to K D Scheppokat.
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The outcome of an aortic dissection is either endothelialisation of the false lumen forming a so-called double aorta, or thrombosis of the sack leading to fibrosis. Healing of an aortic dissection, particularly if thrombosis and organisation have obliterated the dissected segment, is rare and there are only a few case reports on this finding. We report on a case where spontaneous resolution of the false lumen of Type B aortic dissection was demonstrated by serial contrast enhanced computed tomography after antihypertensive medical treatment.
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Clinical and electron microscopic studies of two female patients are reported who, in addition to the symptoms and signs of idiopathic edema, had pericardial (and pleural) effusions. In one patient pericardiectomy had to be performed, in the other patient pharmacotherapy with spironolactone was effective. In these patients the protein-concentrations of edema fluid (25 and 12 g/l) and pericardial fluid (55-61 and 48 g/l) were relatively high; the distribution space of labelled protein was increased; blood volumes were low-normal or decreased. Electronmicroscopy of the microvasculature showed identical alterations in both cases. In the cutaneous vessels the endothelium developed numerous abnormal cytoplasmic processes and intercellular "gaps". In the capillaries of skeletal muscle our findings indicate an increase in vesicular transport. We suggest the electron microscopic alterations to be the morphologic correlate for the increased transport and extravascular accumulation of protein. Changes as they are described here in humans with idiopathic edema have been documented before in animals with experimental edema.
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