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PubMed1985

[Postmortem coronary angiography: the clinico-morphological aspects of its interpretation and the diagnostic value].

Review of literature on the clinico-morphological interpretation and diagnostic value of the postmortem coronarography is presented. Characteristic of a basic coronarographic appearance of obstructive conditions in the heart coronary system, compensatory processes and decompensation of the disturbed coronary circulation is given. Diagnostic symptoms and syndromes are presented from the viewpoint of leading parameters of the coronary hemodynamics.

Aging↗
PubMed1995

Furazolidone toxicosis in young broiler chicks: morphometric and pathological observations on heart and testes.

Broiler chicks 1 d and 3 w of age were given 0, 400, 800, or 1000 mg furazolidone (Fz)/kg feed for 4 w. Bi-ventricular heart dilatation (as measured by increases in ventricular diameter and thinning of the ventricular walls) was present in 1-d-old chicks fed 800 mg Fz, whereas in 3-w-old groups these changes occurred at 1000 mg Fz. There was no heart hypertrophy. Microscopic changes in the heart were not discernible in and Fz-fed birds. The liver had congestion and cytoplasmic vacuolation of hepatocytes. About 37-50% of the male birds in the different Fz-fed groups had testicular degeneration varying from mild to cystic enlargement. The degenerated testes had dilatation of seminiferous tubules; in cystic testes the seminiferous tubules were extremely dilated and had flattened epithelium. The interstitial tissue between the dilated tubules was compressed and atrophic.

Administration, Oral↗
PubMed1986

Nature of the bleeding vessel in recurrently bleeding gastric ulcers.

An unselected consecutive series of 826 patients admitted for acute upper gastrointestinal bleeding underwent urgent endoscopy. Peptic ulcers were found in 402 (49%). Of the 329 ulcer craters that could be fully examined, visible vessels were identified in 156 (47%), other stigmata of recent hemorrhage in 66, and no stigmata of recent hemorrhage in 107. One hundred twenty-nine patients with stigmata of recent hemorrhage (93 of whom had visible vessels) randomly allocated to no endoscopic treatment were observed for evidence of further bleeding. Fifty-four of the 93 patients (58%) with visible vessels rebled, compared with 2 of 36 (6%) with other stigmata of recent hemorrhage. No patient without stigmata of recent hemorrhage rebled. Twenty-seven patients in whom a visible vessel in a gastric ulcer was identified at endoscopy underwent urgent partial gastrectomy because of recurrent bleeding. The vessel identified at endoscopy was found in 26 of 27 resection specimens (96%). The arterial vessel wall protruded above the surface of the ulcer crater in 10 specimens, and clot in continuity with a breach in the vessel wall protruded in a further 10 specimens. Postoperative angiography, when technically possible, showed that the breached artery ran across the base of the ulcer in all of these specimens. Pathological changes were common in the bleeding artery and included arteritis in 24 of 29 (83%) eroded arteries found in these specimens, with aneurysmal dilatation in 14 of 27 (52%) bleeding points that could be fully examined. The ulcer had penetrated to serosa in 13 specimens (45%). The bleeding artery had a mean external diameter of 0.7 mm with a range of 0.1-1.8 mm. This study provides new information about the nature of the bleeding vessel in gastric ulcers, and some of this information is relevant in planning studies of endoscopic therapy for bleeding peptic ulcers. It validates the endoscopic identification of a visible vessel, and confirms that such identification has a high predictive value for the development of recurrent hemorrhage.

Arteries↗
PubMedDate not supplied

Evaluation of the pancreatic duct: a reappraisal based on a retrospective correlative study by sonography and pancreatography in 117 normal and pathologic subjects.

A retrospective study of 117 normal and pathologic pancreatic ducts by endoscopic retrograde cholangiopancreatography (ERCP), with ultrasonic correlation in 80 cases, confirmed the value of ultrasound in the diagnosis of ductal dilatation. The specificity of ultrasound is good: the ultrasonic discovery of a dilatation constitutes a relevant feature. Sensitivity is however poor, particularly in moderate and localized dilatations: a suggestive clinical picture requires ERCP even if sonography is in favor of a normal pancreatic duct. Correlative measurements show discrepancies, with higher ERCP values in normal subjects. The average ERCP diameter in the corporeal ductal segment is 2.6 mm. Until correlative results arising from a prospective study are available, the ultrasonic diagnosis of ductal dilatation must take into account the high normal values demonstrated by ERCP.

Adult↗
PubMed1998

Multiplanar reformatting and three-dimensional reconstruction: for pre-operative assessment of the thoracic aorta by computed tomography.

INTRODUCTION: Conventional CT demonstrates pathology of the thoracic aorta. This study aimed to evaluate the additional contributions to surgical planning of multiplanar reformatting, maximum intensity projections and three-dimensional (3-D) reconstruction. DESIGN: Retrospective. SUBJECT AND METHODOLOGY: Fifty-three patients with newly diagnosed pathology of the thoracic aorta were scanned over a 15-month period; 25 scans were spiral acquisitions. Scans were acquired during and following rapid injection of 100 ml of intravenous iopromide. The reconstructed data was displayed as axial images, oblique or other multiplanar reformats and shaded surface display 3-D reconstructions. Two radiologists and two surgeons reviewed the images. The axial images were assessed initially, subsequently the reformats and 3-D reconstructed views were examined looking particularly for additional information that might add to the surgical management. RESULTS: Pathologies encountered were aortic dissection (21 patients, including two with Marfan's syndrome), saccular aneurysms (eight), fusiform aneurysms (16), aortic root and ascending aortic dilatation (seven) and coarctation (one). The relationship of aneurysms and dissections to major vessels are better shown with 3-D reconstruction or oblique reformats. Morphology of saccular aneurysms, particularly the neck, is well shown with 3-D reconstruction. Coarctation was best demonstrated by oblique reformats. There was little additional information from 3-D reconstruction or reformats in assessment of type A dissection. Improved spatial orientation by visualization in varying projections was helpful for surgical planning in certain cases of type B dissection, fusiform aneurysms and aortic root and ascending aortic root dilatation. Spiral acquisitions have the advantage of speed and hence a greater anatomical coverage for a single breath-hold. CONCLUSION: Oblique reformats and 3-D reconstruction, although using identical data as the axial images, in specific cases were felt to aid surgical assessment of aneurysms and dissections, thus assisting pre-operative planning.

Aortic Dissection↗
PubMedDate not supplied

Tracheo-bronchial stenosis--report of 3 cases.

Three cases of large airway stenosis of different aetiologies are reported. In the first case, tracheal stenosis occurred after endotracheal intubation. The second case developed bronchial stenosis as a sequelae to pulmonary tuberculosis. The third case had localized stenosis of the left main bronchus for which no cause could be found. The first case responded completely to dilatation while the 2nd case demonstrated only partial response. Third case did not improve significantly with dilatation.

Adolescent↗
PubMed1989

[Various characteristics of the structure of the cardiac lymphatic bed and the morphofunctional basis of its insufficiency].

Structural peculiarities of the cardiac lymphatic bed have been studied, as well as its adaptive and pathological changes under physical load, acute and recurrent coronary insufficiency under conditions of mechanical blockade of the lymph outflow from the organ, which have been modelled in dogs and rabbits. The cardiac lymphatic bed is injected with various staining masses and investigated stereoangioscopically in translucent preparations, in semithin slices and electron microscopically. The rearrangement of lymphatic capillaries and vessels revealed is of stereotypical character. The degree of manifestation and correlation of morphofunctional reactions, characterizing development of insufficiency of the cardiac lymphatic vessels is mainly determined by intensity and exposition of pathological effects, exercised on it, while etiologic factors are of less importance.

Animals↗
PubMed1984

The use of endoscopy in assessment and treatment peptic strictures of the esophagus.

In the 1960s, evaluation of peptic strictures of the esophagus was a significant and difficult clinical problem. The use of rigid esophagoscopes and general anesthesia resulted in high complication rates. Most peptic esophageal strictures were managed surgically. The 1970s brought a dramatic change in the management of peptic strictures of the esophagus. With the introduction and widespread use of the forward-viewing, flexible panendoscope for upper gastrointestinal (GI) endoscopy, general anesthesia is no longer needed; evaluation of the peptic stricture has become one of the most common procedures in GI endoscopy. From December 1975 to October 1982, 1000 dilations were performed with a morbidity of 0.2 per cent and a mortality of 0.1 per cent. Initially, radiographic evaluation proximal to, distal to, and at the stricture is conducted. Endoscopic evaluation of the same three areas is then performed with emphasis on determining whether the stricture is benign or malignant. Malignancy can be determined visually in more than 90 per cent of the patients and in more than 95 per cent of the patients with multiple biopsies and cytology. Immediate dilation, using rubber (Maloney) dilators (Pilling Medical Co., Fort Washington, PA) or Eder-Puestow dilators (Eder Instrument Co., Chicago, IL), is then performed. The personality of the stricture determines which dilator can be used with greatest safety.

Biopsy↗
PubMed2006

Successful wireless capsule endoscopy for a 2.5-year-old child: obscure gastrointestinal bleeding from mixed, juvenile, capillary hemangioma-angiomatosis of the jejunum.

The lesion responsible for obscure gastrointestinal bleeding in the pediatric population may not be determined with standard primary endoscopic methods. Wireless capsule endoscopy, now a first-line modality for evaluation of the small bowel in the adult population, is a tool that may be useful among children. We report a case of a 2.5-year-old girl who presented with melenic stools. Upper and lower endoscopy, Meckel scans, and mesenteric angiography yielded negative results. Wireless capsule endoscopy identified numerous abnormal, dilated, blood vessels in the proximal jejunum, with associated fresh blood. The patient underwent surgical exploration, with resection of the affected portion of the jejunum. Pathologically, the dilated blood vessels were consistent with mixed, juvenile, capillary hemangioma-angiomatosis of developmental or congenital origin. The patient fared well postoperatively, with no additional bleeding in 9 months of follow-up monitoring. This case report highlights the use of capsule endoscopy in the diagnosis and successful treatment of gastrointestinal bleeding in a young infant. This is the youngest reported patient treated with the use of wireless capsule endoscopy in the pediatric population.

Angiomatosis↗