[Duodenal dilatation in the treatment of duodenal ulcer and hazards associated with its implementation].
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A case of tracheobronchial stenosis secondary to trauma is presented. Primary reconstruction resulted in stricture in the distal part of the trachea. Resection and anastomosis was followed by restenosis, which had to be treated endoscopically. Endobronchial resections and forceful dilatations with stiff bronchoscopes were done weekly for about 11 months without lasting benefit. After changing to Eder-Puestow dilators, the dilatations could be done at steadily increasing intervals. This method of dilatation was found to be safe, effective and less traumatic.
We report 2 cases of primary megaloureter, which might shed an unconventional insight into the etiology of this controversial issue. On histological studies, using light and electron microscopy, the dilated segment was characterized by sparse muscular development with an unrecognized amount of thick myofilaments and interstitial fibrosis, while the distal few centimeters of the narrowed segment maintained relatively normal muscular and interstitial features. The etiological and clinical implication of these findings in the management of primary megaloureter is discussed.
This article discusses cranial ultrasonography in various clinical settings. Since 1979, the authors have screened all preterm infants for intracranial hemorrhage, and here they present their experience with hemorrhage and its sequel, ventricular dilatation. Also discussed is the use of cranial ultrasonography in infants with seizures and encephalopathy and in infants with abnormal head growth or suspected cerebral malformations.
PURPOSE: To describe the features of pancreatoblastoma at magnetic resonance (MR) imaging, computed tomography (CT), and ultrasonography (US). MATERIALS AND METHODS: Imaging and surgical findings in 10 patients (age range, 2-20 years; mean age, 6.8 years) with pathologically proved pancreatoblastoma were reviewed for tumor size, organ of origin, definition and quality of tumor margins, tumor heterogeneity, calcification, enhancement, ascites, biliary and/or pancreatic ductal dilatation, local invasion, adenopathy, vascular invasion, vascular encasement, metastases, and signal intensity on MR images. Results from 10 CT, seven US, and three MR imaging examinations were reviewed. RESULTS: Five of the 10 tumors were pancreatic; four others appeared to be pancreatic or hepatic. Most had well-defined margins (nine of 10), were heterogeneous (nine of 10), and enhanced (10 of 10). Other findings included calcification (two of 10), biliary and pancreatic ductal dilatation (one of 10), and ascites (three of 10). Hepatic (two patients) and pelvic (two patients) metastases were present. Adenopathy (two patients) and vascular invasion (one patient) were not identified radiologically. Tumors had low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. CONCLUSION: Pancreatoblastoma is typically a heterogeneous tumor with well-defined margins that may appear to arise from the pancreas or liver. It may behave aggressively, with localized vascular or bowel invasion or with widespread metastatic disease. Although it is rare, it should be considered in the differential diagnosis of an upper abdominal mass in a child.
Morphological survey was performed in 140 liver specimens of hepatolithiasis which were collected from several pathological and surgical Departments in Japan. Among them there were 19 cases with unusual features suggestive of presumed lithogenic processes. They consisted of association of congenital dilatation of biliary tree (5 cases), association of stenosis or obstruction of biliary tree occurring prior to lithiasis (4 cases), association of anomalous communication between biliary tree (1 case), presence of serous glands simulating to pancreatic exocrine glands in biliary tree (1 case), association of non-biliary hepatic cirrhosis (4 cases), association of chronic ulcerative colitis (1 case), intrahepatic cholesterol stone (2 cases) and association of granulomatous cholangitis (1 case). Chronic proliferative cholangitis which is consistently seen in a common type of hepatolithiasis was found in about a half of these unusual cases and not in the remaining cases. Based on the observations of these unusual cases, the following suggestions were obtained: dilatation, bile stasis or cholangitis may be a lithogenic factor of hepatolithiasis, and chronic proliferative cholangitis associated with a numerous amount of mucinous glands is not always a prerequisite lesion and exerts a promoting and accelerating effect in hepatolithiasis.
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Dimensions and volumes of 200 hemilarynges were measured to establish the normal range of laryngeal air sac size in males and females. Large saccules reaching the upper border of the thyroid cartilage were unilateral in 23 and bilateral in 20. Saccular volume is significantly related to ventricular volume but not to age, sex or laryngeal size. Large bilateral saccules are common and, therefore, a likely underlying factor in laryngocoele. However, the unilaterality of the disease, its male predominance and its age distribution, suggest that local laryngeal pathologies are perhaps the determinant factor in the pathogenesis of the disease.
This paper presents results from the first UK national survey of patient information and interventions related to vaginal dilation in pelvic radiotherapy (RT). The aim was to elicit current practice with regard to the target population, content/process of patient education, and the evaluation of compliance in relation to this intervention. A 38-item questionnaire was sent to all RT departments (n= 65) and a convenience sample of specialist gynecological oncology nurses (n= 166), with response rates of 62% (n= 40) and 31% (n= 52), respectively. Data analysis (via SPSS v11) used both descriptive and inferential statistics. Divergence of opinion was evident regarding the specific target audience for dilator education, and only a limited number of elements of vaginal dilator technique achieved consensus. Sixty-seven percent of respondents stated they carried out a wider sexual health assessment associated with the provision of dilator information, although its content varied considerably. Results suggest the provision of vaginal dilation advice may benefit from being placed in the wider context of assessing treatment impact on women's sexual health, raising the profile of appropriate psychosexual assessment, and intervention in clinical oncology practice. Further research could determine the efficacy of vaginal dilation in preventing development of vaginal stenosis among women receiving pelvic RT.
The effect of pyelocaliectasis on intrarenal arterial Doppler indices was evaluated in healthy pregnant women with respect to nonpregnant controls. There was no significant difference between the pregnant and nonpregnant subjects regarding the systolodiastolic ratio, resistivity index and pulsatility index throughout the second and third trimesters (p for all > 0.05). There were 134 kidneys with grade 0, 38 kidneys with grade I and 24 cases with grade II pyelocaliectasis in the pregnant population. Grade II caliectasis was found only in the right kidneys. The nonpregnant women all had grade 0 caliectasis. Doppler indices were not significantly different in various grades of caliectasis, and right and left kidneys had similar Doppler indices. The results of this study suggest that pyelocaliectasis increases with advancing gestational age and is more frequent and prominent on the right side but has no effect on intrarenal Doppler indices in healthy pregnant women. In cases of prominent alterations in Doppler indices, renal pathological conditions should be sought.
Mild pyelectasis is a common finding which is often incidental, with no significant long term sequelae. However, there is a small association with aneuploidy and postnatal renal pathology. In this paper the aetiology and prognosis are discussed and the management strategies described.
The character and specific features of the venous blood circulation in lower extremities were determined by clinico-angiographic studies in 358 patients with trophic ulcers resulting from varicose disease of lower extremities. Causes of the formation of the ulcer are analyzed, methods of correcting the disturbed venous hemodynamics are proposed in relation to the pathology revealed. Indications for dissection of the ulcer are developed.
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