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At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Surgical approach to ascending aorta in bicuspid aortic valve.

OBJECTIVE: Former studies have pointed out that hemodynamic stress imposed by associated valvular disease is the primary factor in the development of ascending aorta dilatation. At present, intrinsic wall pathology is blamed for dilatation and aneurysm formation in bicuspid aortic valve (BAV). MATERIALS AND METHODS: Aortic valve replacement (AVR) was performed on 78 adult patients with BAV. Patients were divided into two groups. Group I (n = 27) underwent only AVR. Group II (n = 51) underwent AVR and additional ascending aorta procedures such as Shawl-Lapel aortoplasty (n = 12) and tailoring aortoplasty (n = 9). Dacron wrapping was performed after both techniques were done. Ascending aorta replacement was done on 11 patients by using composite graft. Supracoronary graft replacement was performed in 3 patients after AVR. RESULTS: Ascending aorta diameter increment was 1.25 mm/year in normotensive and 2.80 mm/ year in hypertensive patients. Ascending aorta aneurysm (diameter > 55 mm) developed in eight patients in the postoperative period in group I. Ascending aorta dilatation did not develop in group II patients. Mean survival time +/- standard error (SE) was 128 +/- 11 and 99 +/- 4 months and survival possibility was 77.78% and 92.16%. Freedom from reoperation was 65.4% and 95.9% in 8 years in group I and group II, respectively. CONCLUSION: Aortic wrapping with or without aortoplasty has a beneficial effect not only in dilated ascending aorta but also in all nondilated BAV patients with normal-sized aortic diameter. Ascending aorta wrapping in BAV patients preserves the endothelial lining and prevents further dilatation, aneurysm formation, and dissection.

Adult↗
PubMed1996

Pathological esophageal acidification and pneumatic dilitation in achalasic patients. Too much or not enough?

Endoscopy, esophageal manometry and pH monitoring, gastric emptying test, and heartburn quantification on a visual analog scale were performed in 22 achalasic patients in order to clarify which events are associated with pathological esophageal acidification after successful LES dilatation. Five patients presented pathological acidification. Dilatation reduced LES tone from 38.3 +/- 4.2 to 14.6 +/- 1.1 mm Hg (mean +/- SEM); there was, however, no difference between nonrefluxers and refluxers (14.8 +/- 1.2 vs 13.8 +/- 2.5 mm Hg). The emptying time in achalasic patients was delayed compared to controls (315.9 +/- 20.9 min vs 209 +/- 10.4) due to prolonged lag-phase and reduced slope of the antral section-time curve, but, again, there was no difference between refluxers and nonrefluxers. The acid clearance was delayed in refluxers compared to nonrefluxers (15.9 +/- 4.5 vs 2.5 +/- 1.8 min, P<0.05). Two refluxers presented grade 1 esophagitis; one of them developed an esophageal ulcer. The heartburn score was the same in refluxers and nonrefluxers. Pathological acidification after pneumatic dilatation is associated with persistent problems in esophageal emptying rather than with excessive sphincter divulsion.

Adult↗
PubMed1982

Intrahepatic periductal glands and their significance in primary intrahepatic lithiasis.

Resected hepatic tissues of 24 patients with primary intrahepatic lithiasis were examined histo-pathologically. Calcium bilirubinate stones, cellular debris and mucinous substances occupied the lumen of large dilated intrahepatic bile ducts. Numerous mucin secreting glands were seen within or around the wall of these bile ducts. Similar structures were demonstrated in two patients with non calculous congenital dilatation of the intrahepatic bile ducts. Cholestasis was often absent in the hepatic parenchyma. Production of intrahepatic gallstones may be caused by not only biliary stasis and infection, but also by intraductal mucin and slow flowing bile in combination with cellular debris, bile pigment and other bile components.

Adult↗
PubMed2005

A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating.

AIM: To evaluate the effects of a combination probiotic on symptoms and colonic transit in patients with irritable bowel syndrome (IBS) and significant bloating. METHODS: Forty-eight patients with Rome II IBS were randomized in a parallel group, double-blind design to placebo or VSL# 3 twice daily (31 patients received 4 weeks and 17 patients 8 weeks of treatment). Pre- and post-treatment colonic transit measurements were performed using scintigraphy with (111)In charcoal. Symptoms were summarized as an average daily score for the entire period of treatment and separately for the first 4 weeks of treatment. Weekly satisfactory relief of abdominal bloating was assessed. RESULTS: Treatment with VSL# 3 was associated with reduced flatulence over the entire treatment period (placebo 39.5 +/- 2.6 vs VSL# 3 29.7 +/- 2.6, P = 0.011); similarly, during the first 4 weeks of treatment, flatulence scores were reduced (placebo 40.1 +/- 2.5 vs VSL# 3 30.8 +/- 2.5, P = 0.014). Proportions of responders for satisfactory relief of bloating, stool-related symptoms, abdominal pain and bloating scores were not different. Colonic transit was retarded with VSL# 3 relative to placebo (colon geometric center 2.27 +/- 0.20 vs 2.83 +/- 0.19, P = 0.05 respectively). CONCLUSION: VSL# 3 reduces flatulence scores and retards colonic transit without altering bowel function in patients with IBS and bloating.

Adult↗
PubMed1998

Cardiac sequelae of Kawasaki disease among recurrent cases.

OBJECTIVE: This study was undertaken to clarify whether cardiac sequelae due to Kawasaki disease are more frequent among recurrent cases than initial onset cases. STUDY DESIGN: A cross sectional study using data from nationwide surveys of Kawasaki disease in Japan was conducted. A total of 33,976 patients reported were divided into two groups: initial onset cases (32,923 patients) and recurrent cases (1053 patients). Proportions of cardiac sequelae such as coronary aneurysms/dilatation, coronary stenosis/narrowing, myocardial infarction, and valvular lesions were compared between the two groups. RESULTS: The proportions of patients with the sequelae were significantly more common among recurrent cases. In men 25.5% of the recurrent cases had the sequelae in comparison with 14.9% for initial onset cases, and in women 16.1% of recurrent cases had the sequelae compared with 9.8% of initial onset cases. Giant coronary aneurysms were twice as likely in men in whom the disease was recurring than in initial onset cases, and 1.5 times more likely in women in whom the disease was recurring than in initial onset cases. CONCLUSION: Cardiac sequelae of Kawasaki disease are more likely to appear on recurrent case patients.

Child↗
PubMedDate not supplied

[A comparative analysis of patients with coronary stenotic and ectatic lesions].

A total number of 177 patients with coronary lesions were studied. Sixty nine of them presented either a combination of stenotic and ectatic lesions (n = 18) or isolated ectatic lesions (n = 51) and 108 presented only stenotic lesions. Analyzing several clinical and epidemiological parameters we observed a significant difference with respect to the higher prevalence of hypertension among the group affected by ectatic lesions. We verified as well a higher prevalence of myocardial infarction in the group of ectasia associated to the stenotic lesions. Finally, a higher global mortality was observed in the group of ectasia associated to stenotic lesions after medical or surgical treatment.

Constriction, Pathologic↗
PubMed1978

Interstitial gastric and duodenal emphysema.

A 31-year-old woman developed combined interstitial gastric and duodenal emphysema associated with acute dilatation of the stomach and duodenum following an asthmatic attack. The literature is reviewed.

Adult↗
PubMed2007

Relation of aortic root dilatation and age in Marfan's syndrome.

AIMS: The main aim of this study was to describe the age at which pathological aortic root dilation occurs in patients with Marfan's syndrome (MFS). METHODS AND RESULTS: A total of 160 patients with MFS attending a regional cardiac centre were reviewed retrospectively. Dilation of the ascending aorta was diagnosed by comparing the maximum aortic sinus measurement with control data from the literature. We employed a Kaplan-Meier survival curve to estimate the age at which dilatation occurs. The mean age of the total group at presentation was 15.5 years (range 1.5-40 years). Skeletal abnormalities were present in 95%. Eye involvement was found in 18%. In the 115/160 patients with an abnormal aortic root, 78/115 (68%) developed aortic root dilatation before 19 years of age. From the Kaplan-Meier curve, it can be estimated that about 35% of the patients have aortic root dilatation already at the age of 5 years and 70% before the age of 20 years, and at least 80% by 40 years. There were 31 patients with normal aortic root when first seen but 24/31 (77%) developed aortic root dilatation before the age of 19 years and 7/31 (22.6%) after 19 years of age. Of those (seven patients) who developed new pathological aortic root dilatation after age 19 years, the age range was between 21 and 40 years with a mean of 27 years. Overall, 13 patients (8%) had surgery for aortic root replacement. CONCLUSION: Aortic root dilatation develops early in MFS and was present in 35% by the age of 5 years and 68% by 19 years. Even though new aortic root dilation is relatively rare, it is not possible to safely discharge patients with MFS as about one-third of the patients in our series who developed new pathological aortic root dilation did so after the age of 19 years.

Adolescent↗
PubMed1990

Neuroradiological and pathological studies on neonatal aneurysmal dilation of the vein of Galen.

Neuroradiologic and neuropathologic findings on neonatal aneurysmal dilation of the vein of Galen are reported. Doppler echocardiography revealed a diastolic reversed Doppler signal, which suggested the presence of a cerebral arteriovenous fistula. Cerebral ultrasonography with intravenous injection of contrast medium was useful in the diagnosis. Digital subtraction cerebral angiography clearly demonstrated both the feeding and draining vessels and the aneurysmal dilation of the vein of Galen, although it failed to detect the abnormal vascular channels. Pathologic and histopathologic findings demonstrated intimal thickening of the abnormal vascular channels, which could produce higher vascular resistance and result in the detection failure with digital subtraction angiography.

Cerebral Veins↗
PubMed1996

Validity of ultrasonography for postoperative monitoring in pediatric urology.

PURPOSE: We studied the validity of ultrasonography for short-term followup in pediatric urology. MATERIALS AND METHODS: The study group comprised 137 children (187 urinary tracts) undergoing surgery at our hospital for congenital urological pathology between February 1982 and July 1992. The study protocol designed to evaluate urinary tract dilation postoperatively and monitor its progress, included ultrasound at discharge from the hospital, and repeat ultrasound between days 20 and 30, and days 45 and 60. Diuretic renography or excretory urography was indicated when urinary tract dilatation showed no signs of regressing or had increased on 2 consecutive evaluations. Ultrasound of the urinary tract was done to evaluate variations in the grade of dilatation of the pelves, calices, infundibula and ureters, and grade of hydronephrosis. RESULTS: Variations in the grade of dilatation of the infundibula and ureters were early sensitive indicators of the absence of obstruction. Using this protocol only 15 of the 187 urinary tracts (8%) corrected surgically needed further evaluation for suspected iatrogenic stenosis, including 3 with obstruction that required reoperation. No other cases of obstruction were detected during long-term followup. CONCLUSIONS: A series of sonographic evaluations performed within a short period and the greater significance attributed to more specific parameters, such as grade of dilatation of the infundibula and ureters, make ultrasound a valid means of monitoring urological cases postoperatively.

Adolescent↗