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At least 1,009 records · Page 56Linked to original sources
PubMed2003

Hypertensive intracranial hematomas: endoscopic-assisted keyhole evacuation and application of patent viewing dissector.

OBJECTIVE: To study the effect of endoscopic-assisted keyhole operation (EAKO) on treating hypertensive intracranial hematomas and the value of our patent dissector applied during the operation. METHODS: A total of 25 patients with hypertensive intracranial hematomas underwent endoscopic-assisted keyhole evacuation, during which, the viewing dissector, which had recently achieved national patent, was connected to the tip of endoscope and used to help dissect hematomas. The outcome of this procedure were compared with those of 22 comparable cases undergone conventional surgical treatment (large or smaller craniotomy). The items for comparison included the volume of remaining hematoma, the duration of operation, postsurgical Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS). RESULTS: Remaining hematoma was ascertained 48 h after operation with the use of computerized tomography (CT) scans. In the case of EAKO, nearly complete evacuation (> 84%) was achieved in 21 cases; GCS was evaluated at 7 d postsurgery resulting in GCS > 12 in 9 patients, GCS 9 - 12 in 12 patients and GCS < 9 in 4 patients. The follow-up period ranged from 6 to 21 mon. GOS was estimated at half a year and good recovery rate as defined by GOS was assigned to 76% of the EAKO patients. There are significant differences in the volumes of remaining hematomas and the duration of operation between the EAKO and craniotomy group (P < 0.05). In addition, better clinical outcomes were obtained in EAKO. CONCLUSION: EAKO has the advantage of being minimally invasive, improving surgical results and the prognosis of hypertensive intracranial hematoma patients. We conclude that keyhole operation is a safe, effective alternative for removal of hypertensive intracranial hematoma, particularly during acute stages.

Aged↗
PubMed2003

Successful percutaneous closure of patent foramen ovale seven years after surgical closure.

Through advancements in transcatheter technology, a patent foramen ovale (PFO) can now be closed by either a percutaneous or surgical procedure. This report presents a patient who suffered an embolic stroke secondary to a PFO. The PFO was successfully closed surgically, but 7 years later the foramen ovale was found to be widely patent. The patient underwent successful percutaneous PFO closure and the foramen ovale remains closed. This case demonstrates that percutaneous PFO closure may be viable in patients in whom surgical closure has not provided long-term closure.

Adult↗
PubMed2003

Anaphylaxis due to patent blue dye during lymphography, with negative skin prick test.

We report here a case of anaphylaxis due to patent blue dye, which was administered to an adult female during a lymphographic intraoperative procedure. The patient was not atopic, and other possible causes of anaphylaxis (anesthetics, latex) had been carefully excluded through routine tests. The skin-prick test and patch test carried out with patent blue (PB) dye were negative, but the intradermal test with 100 microliters of the dye showed a remarkable positivity. There was no available commercial, specific IgE assay for PB dye, but the negativity of prick tests would exclude the involvement of an IgE-mediated mechanism. We want to highlight the possible danger derived from a dye that is considered inert, and that is now increasingly being used in surgical procedures.

Anaphylaxis↗
PubMed2003

Transcatheter occlusion of moderate to large patent arterial ducts, having a diameter above 2.5 mm, with the Amplatzer Duct Occluder. Comparisons with the Rashkind, buttoned devices, and coils in 116 consecutive patients.

AIM: To report results of transcatheter occlusion of moderate to large patent arterial ducts, having a minimum diameter above 2.5 mm, with the Amplatzer duct occluder, and to compare these with results achieved using Rashkind or Sideris devices and Cook detachable coils. DESIGN AND SETTING: Retrospective study conducted on intention-to-treat data from a tertiary referral centre. PATIENTS: Since 1989, 116 consecutive patients, 77 females and 39 males, underwent percutaneous closure with several devices. We used the Rashkind double umbrella in 23 patients, the Sideris buttoned device in 39 patients, coils in 17 patients, and the Amplatzer duct occluder in 37 patients. The median age of the patients was 37 months, and the median weight 13 kg. The mean minimum diameter of the duct was 3.8 +/- 1.22 mm, with a median of 3.5 mm, and range from 2.5 to 10 mm. RESULTS: Implantation succeeded in all but 9 of the children (92%). The time of fluoroscopy was shorter, and full occlusion was better as judged on angiography, in patients closed using the Amplatzer device, despite closure of larger ducts, than in patients closed using other devices (p < 0.0001, p = 0.0003, and p = 0.0015 for the Rashkind, Sideris, and coils, respectively). Complications included embolisation in 2 patients, and haemolysis in 3 patients. In 12 patients, a second device was inserted because of residual shunting noted during follow-up. Complete occlusion was achieved earlier after implantation (p = 0.0002), and the rate of complete occlusion was better in patients receiving an Amplatzer device (97%, p = 0.024) than in patients undergoing closure with other devices. CONCLUSION: Transcatheter closure of moderate to large patent arterial ducts using the Amplatzer duct occluder is an effective and safe procedure, providing better results than those achieved using other occluders.

Catheterization↗
PubMed2004

Limited Left Thoracotomy for Reoperative Coronary Artery Bypass Grafting without Cardiopulmonary Bypass for Circumflex Grafting in Patients with Patent Internal Thoracic Artery Graft.

Abstract Background: We describe our experience with the limited left thoracotomy strategy for reoperative coronary artery bypass graft (CABG)to the circumflex coronary artery system, emphasizing the indications, our particular operative technique, and early clinical follow-up. Methods: From January 2001 to January 2002, 8 consecutive patients underwent redo revascularization via limited left thoracotomy and without cardiopulmonary bypass. This operation was indicated for patients with recurrent myocardial ischemia confined to the lateral wall of the left ventricle, especially if a patent left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD)graft was present. Results: All 8 patients underwent successful redo revascularization via limited left thoracotomy. Eight patients received 14 saphenous vein grafts (mean 1.7 grafts/patient). No instances of postoperative myocardial infarction or death occurred. During a follow-up period ranging from 1 to 12 months (mean, 5. 2 months), all patients were asymptomatic and without evidence of ischemia or infarction. Conclusions: For select patients who have patent LITA grafted into the LAD and who need redo CABG to the coronary artery circumflex system, the limited left thoracotomy approach without cardiopulmonary bypass is a safe operation and a less invasive alternative to repeat sternotomy and conventional CABG.

Journal Article↗
PubMed2004

[Reliability of cardiac magnetic resonance imaging indicators of myocardial viability for predicting the recovery of systolic function after a first acute myocardial infarction with a patent culprit artery].

INTRODUCTION AND OBJECTIVE: To assess the reliability of early analysis of the most frequently used cardiac magnetic resonance (CMR)-derived indexes for predicting systolic function recovery and ventricular remodeling in patients after a first acute myocardial infarction with a patent culprit artery. PATIENTS AND METHOD: 17 patients were studied with an initial CMR protocol that included regional assessment of wall thickness and wall thickening, low-dose dobutamine response, first-pass gadolinium myocardial perfusion imaging and delayed enhancement. These results were compared with those obtained for segmental and global function in a second CMR study 6 months later. RESULTS: Of the 272 myocardial segments evaluated in the initial study, 73 showed severe systolic dysfunction. The findings were used to calculate sensitivity and specificity of each of the indexes mentioned above for predicting myocardial viability. The sensitivities and specificities for each index were wall thickness > or =5.5 mm, 100% and 12%; low-dose dobutamine response, 41% and 93%; normal myocardial perfusion, 78% and 68%; delayed enhancement, 81% and 95%. Multivariate analysis showed that delayed enhancement was the only independent predictor of contractility (r=-0.83, P=.0001), ventricular volumes (end-diastolic: r=0.61, P=.009, end-systolic: r=0.67, P=.003) and ejection fraction (r=-0.73, P=.001) at 6 months. CONCLUSIONS: Delayed enhancement seen in CMR is a reliable, quantifiable index for predicting recovery of systolic function and ventricular remodeling in patients after a first infarction with a patent culprit artery.

Female↗
PubMed2004

[Detection of the sentinel lymph nodes in lung carcinoma cases using patent blue and its clinical significance].

INTRODUCTION: Views on significance and the most appropriate approach to lymphadenectomy in the non-small-cell lung carcinoma cases, have not been consistent. The method of the sentinel lymphonode identification and biopsy, which has been verified for other tumor types, may become a promising alternative or, at least, a supplement to currently applied procedures in cases of the lung carcinoma. STUDY GROUP AND RESULTS: This prospective, non-randomized study was conducted in the Faculty Hospital in Olomouc between the years 2000-2003. The sentinel lymphonode identification was conducted in the group of 48 patients suffering from the non-small cell lung carcinoma, using the patent blue lymphatic mapping method. The sentinel lymphonode was identified in 40 patients (83.3%), a false negativity of the sentinel lymphonode was detected in 3 cases (7.5%). CONCLUSION: The study proved the clinical benefit of the sentinel lymphonode identification and biopsy method in cases of the non-small cell lung carcinoma using the patent blue dye. Under the circumstance of certain experience with the technology, the reliability of the detection approaches that of the radionuclide sentinel lymphonode detection method. However, the clinical significance of the above method must be further tested on larger patient groups.

Aged↗
PubMedDate not supplied

A case of patent ductus venosus with pulmonary arterio-venous fistula as a rare and unique clinical entity.

A 13-year-old boy presenting with digital and lip cyanosis, easy fatigability, and weight gain was diagnosed to have an intrapulmonary arterio-venous fistula. During his routine follow-up examinations, there was fullness on right upper quadrant of his abdomen. Abdominal ultrasonography (USG) showed a mass in portal hilus. We planned abdominal computed (CT) to gain tomography detailed information about the mass. Surprisingly abdominal CT and the color-Doppler sonography showed that the structure mimicking a mass was patent ductus venosus (PDV). We report PDV with intrapulmonary arterio-venous fistula as a unique and rare clinical entity. In addition, we underline the misdiagnosis of portal mass instead of patent ductus venosus. If there is a portal mass in USG or CT, color-Doppler sonography or, if needed, other diagnostic methods should be used to exclude PDV.

Adolescent↗
PubMed1992

[Patent urachus in childhood].

Over the past 20 years (1971-1990) 12 infants and children have been treated surgically for a partial or totally patent urachus in the Surgical Unit of the University Children's Hospital of Pécs, Hungary. This anomaly is of special interest to pediatric surgeons, general surgeons, urologists, paediatricians. After a short survey of the embryology and pathology of the urachus, the authors analysed their material. All but one of their patients underwent surgery without serious complications. In a 6-year-old girl the urachus recanalized following shrinkage of the bladder. The authors emphasize the need of radical removal of the partial or totally patent urachus, however, this extirpation should be carried out in a froid state, frequently following incision and drainage of the suppurating urachus.

Child↗
PubMed2002

HMG-CoA reductase inhibitors - a review of the recent patent literature.

Statins are very potent inhibitors of HMG-CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis at the mevalonate level. Today there is an increasing tendency to treat hypercholesterolemia aggressively, hence, the greater use of statins worldwide. The pleiotropic effect of statins is well documented. Examination of the patent literature reveals that in the past year pharmaceutical companies continued to be very active in this area. Accumulated knowledge of the actions of statins shows that they may be involved in many more processes than originally anticipated. Hence, in addition to 'old' indications (hypercholesterolemia, hyperlipidemia and atherosclerosis) many patent applications published in 2001 attempted to cover combination therapies, widening indications for statins to almost all known diseases. Many of the 'new' claims are not well substantiated and biological data are absent. Based on the magnitude of cardiovascular disease and aging population globally this area of drug discovery will continue to be an important area of research for all pharmaceutical companies.

Journal Article↗
PubMed2004

Reoperations in patients with patent left internal mammary artery.

In the past decade the rate of reoperative coronary bypass grafting has averaged 8%. In these patients adequate myocardial protection is often difficult because delivery of cardioplegia is frequently suboptimal when the internal mammary artery graft is patent. We describe a simple technique for performing cardiac reoperation in patients with a patent left internal mammary artery graft through a balloon catheter used for angioplasty and positioned in the left internal mammary artery graft. Our study included 3 patients and there were no operative deaths and complications.

Aged↗
PubMed2005

Patent foramen ovale in scuba divers. A report of two cases and a brief review of the literature.

Scuba diving (diving with a self-contained underwater breathing apparatus) has become a popular sport. Decompression illness may be due to the formation of gas bubbles in various body tissues at an increased ambient pressure. The gas can pass from the systemic venous circulation into the arterial circulation as a result of either pulmonary barotrauma or intravascular shunting. Gas emboli may be the cause of an increased prevalence of brain lesions in sport divers. The management of scuba divers (professionals and amateurs) with a patent foramen ovale is not clear. We present the cases of 2 subjects with decompression illness and a patent foramen ovale and briefly review the literature on this combination.

Adult↗
PubMed2004

[Patent foramen ovale and stroke].

About a quarter of the adult population is known to have a patent foramen ovale, rarely accompanied by the presence of an interatrial septal aneurysm. A patent foramen ovale is found in more than 40% of patients younger than 60 years who had a cryptogenic ischemic stroke. Clinical and echocardiographic parameters allow the identification of patients at high risk of recurrence after a first cryptogenic stroke even if treated with Aspirin. A multidisciplinary approach allow the selected patients to benefit of a correction of their cardiac anomaly with promising long term results.

Adult↗
PubMed2000

Factor Xa inhibitors--a review of the recent patent literature.

This review covers the patent literature and related scientific reports in the field of factor Xa inhibitors published between January 1999 and June 2000. During this time, the amount of scientific information as well as the number of newly published patent applications has continuously increased. It is the aim of this review to give an overview of the different structural types of factor Xa inhibitors, to clarify the relationship between newly claimed and previously known inhibitors, and assess the clinical potential of the different factor Xa inhibitors.

Journal Article↗
PubMed2005

Device closure of a patent foramen ovale in a patient with lipomatous hypertrophy of the atrial septum.

The presence of a patent foramen ovale has been recognized as a risk factor for embolic stroke, and transcatheter device closure of patent foramen ovales is increasingly performed to reduce future neurological events. The present report discusses a patient who continued to have residual shunting following percutanous closure because of improper seating of the device in the presence of a lipomatous atrial septum.

Cardiac Catheterization↗
PubMed2002

[Determination of andrographolide and dehydroandrographolide in Andrographis paniculata nees materials and related patent medicines by reversed-phase high performance liquid chromatography].

A simple and accurate method for the determination of andrographolide and dehydroandrographolide in andrographis paniculata Nees materials and patent medicines with high performance liquid chromatography (HPLC) has been developed. The two components were extracted from powdered samples by shaking with methanol. The resultant extracts were separated within 15 min on a BECKMAN C18 column (4.6 mm i. d. x 250 mm, 5 microm) and with a gradient elution of acetonitrile-water at a flow rate of 0.5 mL/min. The detection wavelength was 225 nm and the injection volume was 20 microL. In gradient elution program the volume fraction of acetonitrile in mobile phase was as follows: 0 min - 1 min, 40%; 1 min - 5 min, 40% - 50%; 5 min - 15 min, 50% - 70%. Both andrographolide and dehydroandrographolide have good linearity in the range of 10 mg/L to 100 mg/L with the correlation coefficients of 0.997 6 and 0.998 6 respectively. This method has been successfully applied for the analysis of andrographis paniculata Nees materials and related patent medicines.

Andrographis↗
PubMed1991

The frequency of patent foramen ovale in patients with ischemic stroke: a transesophageal echocardiographic study.

Transesophageal echocardiography has been described as superior to transthoracic echocardiography in the detection of patent foramen ovale (PFO). Utilizing both methods, we were able to determine the frequency of PFO in younger adult patients with ischemic stroke (patient group) and in age-matched control subjects (control group). Thirty-four patients under 55 years of age with cerebral or retinal ischemic attacks (mean age 39 years) and 40 controls (mean age 39 years) were studied. Transesophageal echocardiography detected a significantly higher frequency of PFO in the patient group (44%) than in the control group (18%, p less than 0.05). In comparison with transthoracic echocardiography, transesophageal echocardiography found a higher frequency of PFO in both the patient group (12% vs 44%, p less than 0.01) and the control group (3% vs 18%, p less than 0.05). All of the foramina proved to be patent by transthoracic echocardiography were also found by transesophageal echocardiography. The results suggest that transesophageal echocardiography is a sensitive method for demonstrating PFO. Paradoxical embolism through an interatrial communication (PFO) may be a possible cause of strokes in the young adult.

Adult↗