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At least 541 records · Page 30Linked to original sources
PubMed1993

Follow-up using magnetic resonance imaging in adult patients after surgery for aortic coarctation.

Functional impairment, aneurysma formation, and restenosis are well known complications after surgery for coarctation of the aorta. In order to assess long-term results, 25 adults were studied by physical examination, exercise tests, and magnetic resonance imaging after an interval ranging from 1 to 28 years since surgery for coarctation. Fifteen patients had arterial hypertension at rest, five additional patients showed hypertension on exertion only. Magnetic resonance imaging showed pathological changes of the aorta in all patients. An aneurysm of the ascending aorta was seen in four patients, a circumscript aneurysm in the descending aorta at the site of surgery was found in three patients. Restenosis of the descending aorta occurred in three patients. In eight patients the left subclavian artery was distally displaced and dilated in eleven patients. In order to initiate appropriate treatment of specific complications such as restenosis, aneurysm, and arterial hypertension, regular checks are necessary in patients with surgery for aortic coarctation. In addition to clinical examination and exercise tests, magnetic resonance imaging is an effective noninvasive imaging method for follow-up.

Adolescent↗
PubMed1986

Endourologic approach to transplant kidney.

Two significant procedures, namely lithotripsy of staghorn calculus and dilatation of a stenotic calyceal infundibulum, were performed endourologically in a renal allograft drained by an ileal conduit. This is another example of the versatility of these minimally invasive urologic methods.

Adult↗
PubMed1983

Endoscopic cholangiopancreatoplasty: hydrostatic balloon dilation in the bile duct and pancreas.

Specially designed catheters containing durable polyethylene balloons have been employed in the treatment of strictures of the bile duct and pancreas and the sphincter of Oddi during the performance of endoscopic retrograde cholangiopancreatography (ERCP). Twenty-four patients with strictures of the distal common bile duct and/or dysfunction of the sphincter of Oddi and six patients with proximal biliary strictures comprised the biliary group, while six patients with strictures of either the primary pancreatic duct or accessory systems made up the pancreatic group. No significant complications occurred following biliary dilation, while uncomplicated, mild pancreatitis was associated with pancreatic manipulation. The early results of hydrostatic dilation are encouraging, but larger series and longer term follow-ups are necessary before its efficacy can be determined.

Adult↗
PubMed1980

Percutaneous transluminal angioplasty of the iliac artery.

Stenosis in the right common iliac artery of a 61-year-old man was manifested as pain in the right leg and foot and cyanosis of the second and third toes. Dilatation of the lesion was performed using a Grüntzig catheter; arteriography and measurement of femoral artery pressure confirmed a successful result. The patient was pain free at six-month follow-up. Dilatation of stenoses by percutaneous transluminal angioplasty provides an alternative to conventional operative procedures, with lower cost and morbidity plus an acceptable success rate.

Angiography↗
PubMedDate not supplied

Duct ectasia due to mucus-producing cancers with intraductal extension: histopathologic correlation with radiologic imagings.

BACKGROUND: Although duct ectasia due to mucus-producing pancreatic cancer has been well known, its occurrence in other organs has not been reported. We have studied the pathologic basis of the radiologic features in cases of mucus-producing cancer with intraductal extension. METHODS: We conducted a comparative study of detailed various radiographic images and pathological findings in 10 cases of mucus-producing cancers (four of mucus-producing pancreatic cancer, two of mucinous gastric cancer with diffuse lymphangitic liver metastasis, and four cases of bronchoalveolar cell carcinoma with cyst or cavity). RESULTS: When mucus-producing cancer occurs in a secretory duct or extends into lymphatic ducts, the normal duct is dilated due to the mucus and increased internal pressure, leading to the formation of a cyst and cavity. Because of having the liquid property of mucus floating cancer cells, the lesion can easily progress to continuous ducts as well as regionally. CONCLUSIONS: In cases of mucus-producing cancer with extension into the ductal structure not only in the pancreas but also in the lung and liver, continuous duct ectasis and cysts filled with mucus or cavities of all sizes made by the nature of the mucus may be detected by CT and US.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1997

[Diagnosis and treatment of obstructive seminal vesicle pathology].

Ejaculatory duct(s) obstruction(s) (EDO) may be responsible for as much as one third of azoospermia- or severe oligospermia-related infertility; it's clinical presentation also includes some low urinary tract irritative symptoms, such as repeated epididymitis, pelvi-perineal pain, hematospermia and other ejaculatory disturbances. The diagnosis of EDO is based on patient's history, semen analysis (hypospermia, azoospermia, low fructose level), and transrectal ultrasound (TRUS), which can demonstrate seminal vesicle(s), vas ampulla(s) and/or ejaculatory duct(s) dilatation, Müllerian or utricular cyst, and ejaculatory duct(s) or seminal calcification(s). Confirmation of the suspected diagnosis, if needed, requires classical vasography or TRUS-guided seminal tract puncture and vesiculography. Treatment is usually successfully achieved with transurethral endoscopic procedures: retrograde ejaculatory duct(s) catheterisation, dilatation, incision or resection; seminal tract endoscopy is seldom performed. Very few complications occur; evaluation of long term results is lacking. Indications of such endoscopic procedures remain to be defined, especially in cases of partial EDO.

Blood↗
PubMed2005

Custom made alar stents for nostril stenosis: a 24-month evaluation.

Nostril stenosis is an uncommon deformity and its aetiology is variable. The shape alteration and nostril asymmetry may have negative aesthetic and functional effects on nostril stenosis patients. Five patients were included in this study and followed up for 24 months; four of these had congenital nostril stenosis and one had an acquired deformity. Alar stent dilators were constructed from measured diameter of the affected nostril/s. The congenital nostril stenosis patients initially received a customised chairside soft nasal dilator (CCSND), which were later replaced with a customised laboratory rigid nasal dilators (CLRND). Treatment outcomes were evaluated using a questionnaire and a visual analogue scale to assess improvements in nostril breathing, comfort, appearance and satisfaction of the treatment provided by both types of dilators. There was improvement in nostril diameter with an average expansion of 7mm and this was stable at the desired diameter. The overall number of stents used to expand the tissues to the desired dimension ranged from 3 to 8 stents. Alar stent therapy is a conservative method to expand nostril tissues and has successfully maintained the nostril diameter for both acquired and congenital stenosis. This improvement in all parameters and the patients' satisfaction would make the custom-made nostril dilator in particular the CLRND a satisfactory treatment modality for congenital and acquired nostril stenosis.

Adolescent↗
PubMedDate not supplied

[Colonoscopic dilator: a new instrument in the management of benign stenosis of the colon and rectum].

Experience with a colonoscope with a distal segment that allows for the incorporation of dilating olives of the Eder Puestow type is presented. 15 patients with the diagnosis of benign stenosis of the colon or rectum who suffered of abdominal pain and constipation were treated. In 13 patients it was possible to eliminate the patients symptoms. There where no complications. The dilating colonoscope is a valid, alternative in the management of stenosis of the colon and rectum.

Colonic Diseases↗
PubMed1989

[Interventional radiology of benign bile duct diseases].

The authors describe percutaneous interventional procedure for bile duct benign disease from our own experiences and review of the literatures. Percutaneous dilatation of bile duct stricture is widely employed but is associated with 20-30% recurrence rate. It may be the limitation of present procedure and controversy still exists about long-term post dilatation stent. Self-expandable stainless steel stent have potential advantage and it's future development is expected. Percutaneous removal of common bile duct from percutaneously placed biliary drainage is not routine procedure. Endoscopic sphincterectomy is preferred as initial non-surgical treatment. But recent technological improvement makes this technique safe and simple. Balloon dilatation of Ampullar of Fater and extraction of stone into the duodenum is a effective alternative to endoscopic sphincterectomy. Percutaneous removal of multiple intrahepatic stones with choledochoscopic guidance is well accepted method. Adequate selection of access route and balloon dilatation of multiple stenosis are essential for a success. Extra-corporal shock wave lithotripsy is one adjunct in difficult cases.

Adult↗
PubMed1975

Bacteriological and pathological studies of the "collapse syndrome" in suckled calves.

During the winter of 1971-72 faecal samples from 91 diarrhoeic calves, 25 of which were considered to be suffering from the "collapse syndrome" were examined bacteriologically. E coli of serotypes reported as having the ability to produce enterotoxins were isolated from most of the calves with the "collapse syndrome", but from only a few of the other diarrhoeic calves, as well as a few unaffected in-contact animals. On post mortem examination, abomasal dilatation was a characteristic finding in calves dying of the "collapse syndrome" but not of other diarrhoeic deaths. The significance of these findings is discussed.

Abomasum↗
PubMed2004

Hyperlipidemia aggravates renal disease in B6.ROP Os/+ mice.

INTRODUCTION: Reduction of renal mass is frequently associated with progressive loss of kidney function. We examined the effects of hyperlipidemia on renal pathology and mediators of tissue damage in B6.ROP Os/+ mice, a model of reduced renal mass. METHODS: C57BL/6 control mice and B6.ROP Os/+ mice were fed normal rodent chow or a high fat, high cholesterol (HFHC) diet for 12 weeks. Kidney function and renal pathology were assessed. RESULTS: Hyperlipidemia led to a decline in kidney function in C57BL/6 mice. Renal pathology was characterized by an increase in glomerular matrix and cellularity, glomerular and tubulointerstitial macrophage influx, and increased tubular epithelial cell turnover. Chow-fed B6.ROP Os/+ animals demonstrated glomerular hypertrophy with an increase in mesangial matrix and cellularity that was characterized by macrophage influx and increased proliferation. The tubulointerstitium showed increased macrophages as well as tubular atrophy and dilation. Renal pathology was accompanied by an increase in blood urea nitrogen (BUN) and proteinuria. Hyperlipidemia in B6.ROP Os/+ mice resulted in increased plasma BUN compared to chow-fed B6.ROP Os/+ animals and aggravated renal pathology by further increasing glomerular matrix and glomerular hypercellularity. Glomerular hypercellularity was associated with increased expression of platelet-derived growth factor-B (PDGF B) and its receptor beta. Glomerular transforming growth factor-beta (TGF-beta) mRNA expression was increased in B6.ROP Os/+ mice, hyperlipidemic C57BL/6 mice and hyperlipidemic B6.ROP Os/+ animals compared to controls and correlated with the amount of mesangial matrix. CONCLUSION: This study demonstrates that hyperlipidemia worsens renal pathology in B6.ROP Os/+ mice with a decline in renal function mediated at least in part through increased renal expression of the cytokines PDGF B and TGF-beta.

Animals↗
PubMed1990

Endoscopic dilation of colonic postoperative strictures.

After the use of surgical staplers had become widespread, the number of colonic postoperative stenoses was observed to have increased. Nevertheless, the clinical relevance of this observation is minimal since only 2-5% of the patients complain of chronic constipation or obstruction symptoms. In such cases medical therapy is somewhat troublesome, and surgical treatment always implies a major operation. Endoscopic dilation has proved to be a reliable, simple, and safe therapeutic alternative. Forty-two patients with evidence of stenosis of either colocolic or colorectal anastomosis underwent mechanical or pneumatic dilation in our unit: 19 patients with a temporary diverting stoma were dilated before the colostomy was removed; in the remaining 23 cases, treatment was given according to the patients' symptoms or because it was not possible to pass the anastomosis with an endoscope. The overall failure rate was 2.4%, and no morbidity or mortality was found. When the percentages of patients successfully treated in one session alone were compared (76.9% versus 51.8%), balloon dilation was found to be more effective than bougienage. In our opinion, endoscopic dilation represents the mainstay of treatment of colonic anastomotic strictures, with surgery being reserved for the rare failures, when recurrence of cancer should be suspected.

Aged↗
PubMed1997

Cervical dilatation during ovum pick-up in patients with cervical stenosis: effect on pregnancy outcome in an in vitro fertilization-embryo transfer program.

OBJECTIVE: To evaluate the results of cervical dilatation during an ovum pick-up session in patients with cervical stenosis who participated in an IVF-ET program. DESIGN: A retrospective study. SETTING: In vitro fertilization-ET unit. PATIENT(S): Forty-one treatment cycles in 22 patients with known cervical stenosis. In all patients previous transcervical ET had been either extremely difficult or impossible. INTERVENTION(S): Cervical dilatation under general anesthesia during an ovum pick-up session, 48 hours before transcervical ET. MAIN OUTCOME MEASURE(S): Ease of ET procedure and clinical pregnancy rate (PR). RESULT(S): Cervical dilatation was performed in 41 IVF-ET cycles and resulted in easier transcervical ET in 39 cycles, but only one clinical and one extrauterine pregnancy. CONCLUSION(S): Cervical dilatation during the ovum pick-up session leads to easier ET in patients with cervical stenosis, but PRs after this procedure are very low.

Adult↗
PubMed2002

Pathomorphology of esophageal and gastric varices.

In this article, the gross pathology of varices and supplying veins are described comparing esophageal varices and varices of the cardia and fundus of the stomach. The angioarchitecture of the lower esophagus is such that normally very thin parallel veins in the lamina propria mucosae in the palisade zone become enlarged in portal hypertension and join the few larger submucosal veins to form esophageal varices. Enlarged parallel veins come to pile up and join the submucosal veins at an acute angle, rendering this area vulnerable to rupture. Most ruptures occur in this critical area. The basic differences between esophageal and gastric varices are the layers in which the varicose veins form: the lamina propria mucosae and submucosa in the esophageal varices and the submucosa in gastric varices. While cardiac veins and varices are continuous with esophageal varices, fundic varices develop independently as part of a splenogastrorenal shunt that runs through the stomach wall, having rare communications with other veins. The fundic varix is so large in caliber that when it ruptures, the muscularis mucosae and lamina propria are penetrated with massive bleeding. The treatment of varices calls for complete thrombosis of all varicose veins, and merits and demerits of available treatment modalities are discussed based on autopsies from the pathologic point of view. Because of the large size, the management of fundic varices is difficult, and the new technique called balloon-occluded retrograde transvenous obliteration for occluding fundic varices is discussed.

Cardia↗
PubMed1996

Pulmonary autograft reoperation: incidence and management.

BACKGROUND: Pulmonary autograft replacement of the aortic valve is accepted in the young, those with an active life style, and those who are not candidates for anticoagulation. However, concern remains about autograft or homograft valve failure. METHODS: One hundred ninety-five operative survivors of the Ross operation (August 1986 through December 1995) were reviewed for operative pathology and factors associated with reoperation or valve dysfunction. RESULTS: Actuarial freedom from reoperation (autograft or homograft) is 89% +/- 3% at 5 years, 92% +/- 3% for the autograft alone. Early autograft valve failures (< 6 months) were due to technical error in 2 patients and persistent endocarditis in 1. Late autograft valve failure (1 to 6.2 years) was due to aortic annulus dilatation in 5 patients, bacterial endocarditis in 1, and valve degeneration in 2. Six autograft valves were replaced and five were repaired. Five patients required reoperation for pulmonary homograft stenosis (1 to 5.4 years) involving obstruction of the conduit distal to the pulmonary valve. CONCLUSIONS: Pulmonary autograft replacement of the aortic valve has a low incidence of reoperation for autograft dysfunction or homograft obstruction. Autograft dysfunction can be corrected by autograft repair in patients with central insufficiency and aortic annular dilatation.

Actuarial Analysis↗
PubMed1987

Balloon dilation for the treatment of stomal stenosis complicating gastric surgery for morbid obesity.

In a retrospective analysis, we evaluated our results with endoscopic dilation of enterostomy stenoses that complicated gastric procedures performed for the treatment of morbid obesity. Of 541 patients who underwent a gastric procedure for treatment of morbid obesity, we found 19 patients in whom endoscopic dilations of stenoses had been attempted. We also include three patients who had surgery elsewhere but who underwent dilations at our institution. Fourteen had stenoses complicating gastric bypass with Roux-en-Y anastomoses, and eight had stenoses complicating a gastroplasty (gastrogastrostomy). Two different types of dilation were attempted during the interval reviewed--Fogarty balloon dilations and Grüntzig balloon dilations. None of the eight patients with gastroplasties benefited from the attempted dilation, but 10 of the 14 patients with stenoses complicating gastric bypasses have done well. We found no significant difference between Fogarty and Grüntzig balloon dilations. We conclude that balloon dilation is an effective means of treating stenosis that complicates gastric bypass performed with Roux-en-Y anastomoses in cases of morbid obesity.

Adult↗
PubMed1999

Stent retriever for dilation of pancreatic and bile duct strictures. brand@uke.uni-hamburg.de.

BACKGROUND AND STUDY AIMS: Dilation of high grade strictures of pancreatic or biliary ducts using dilating or balloon catheters may fail. We evaluated the efficacy of the 7-Fr Soehendra Stent Retriever used as a dilator. PATIENTS AND METHODS: Following sphincterotomy, the stricture was first negotiated with a 260 cm long 0.032-inch J-type Terumo wire. Dilation was then attempted using a 7-Fr dilating catheter. If the stricture could not be traversed, the 7-Fr Stent Retriever was inserted over the Terumo wire to dilate the stricture. Between May 1996 and January 1997, the Stent Retriever was used for dilation in 32 patients with biliary or pancreatic duct strictures. RESULTS: The indication for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was symptomatic chronic pancreatitis in 21 patients (twelve men, nine women; mean age 45.7, range 26-70). The mean length (+/-SD) of the pancreatic duct strictures was 20mm+/-10 (range 3-55) with a prestenotic ductal diameter of 9mm+/-2 (range 2-15). Out of 21 patients, nine suffered from pancreaticolithiasis and were treated with extracorporeal shock wave lithotripsy. All but three patients underwent successful stenting in the same session. Another 11 patients (four men, seven women; mean age 67.4, range 47-85) had cholestasis because of benign or malignant bile duct strictures. The mean length of the strictures was 20mm+/-5 (range 3-40), and the mean prestenotic diameter was 10mm+/-5 (range 4-21). Stenting was easily done in all of these patients in the same session. Symptom relief was observed within the first week after stenting in all patients with a biliary or pancreatic stricture. In seven cases, material for cytological examination was obtained from the bile duct, which revealed malignancy in two cases. There was no complication associated with the use of the Stent Retriever. One subcapsular liver perforation was caused by the guide wire and occurred prior to the use of the Retriever. CONCLUSIONS: Tight pancreatic and bile duct strictures can be dilated successfully with the Stent Retriever. The procedure is of low risk. In addition, tissue sampling is possible in some cases.

Cholestasis↗
PubMed2002

Management of traumatic urethral disruption in children: Oman experience, 1988-2000.

BACKGROUND: Traumatic urethral disruptions in children differ anatomically from those of adults. In children, the posterior urethra is not protected by the prostate and may be injured at any level. The management of traumatic rupture of the urethra still a matter of debate, and there is no agreement as to which is the best of 3 options. METHODS: This was a retrospective analysis. Over a 12-year period the authors dealt with 21 urethral disruptions. The authors had detailed follow-up of 20 patients (14 posterior and 6 anterior). Trans-symphyseal urethroplasty (6 early primary repairs and 3 delayed repairs) for complete posterior urethral disruptions was performed. The early repairs were carried out within 7 days of the injury. Primary alignment was performed for 3 of the 4 partial ruptures of the posterior urethra and for all 6 anterior urethral disruptions. Postoperatively, the patients were evaluated for incontinence, penile erectile dysfunction, and stricture formation. RESULTS: In one of the early repairs a stricture developed that responded to dilatations. A second patient with bladder neck injury had incontinence after the repair. She underwent a urethral lengthening procedure and still has stress incontinence. Erections were observed in all 4 boys. One of the delayed repairs developed a stricture postoperatively. Of the 9 partial ruptures (6 anterior and 3 posterior) that underwent primary alignment, 4 had strictures. Some of these strictures required up to 5 dilatations or internal urethrotomy for cure. One patient with complete rupture underwent primary alignment, which broke down, and a long stricture developed. This patient is still awaiting a delayed repair. One posterior partial rupture, repaired primarily at another hospital, had a stricture and an urethrocutaneous fistula that responded to curettage and dilatations. CONCLUSIONS: Primary repairs required less hospitalization and a shorter duration of indwelling catheters. In light of this experience the authors recommend a primary repair in patients with complete posterior urethral disruptions.

Age Factors↗