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At least 127 records · Page 7Linked to original sources
PubMed2004

Iliac vein compression in an asymptomatic patient population.

OBJECTIVE: May-Thurner syndrome is a well-recognized anatomic variant that is associated with the development of symptomatic acute venous thrombosis of the left iliac vein. However, the natural frequency of compression of the left iliac vein and its clinical significance in asymptomatic disease has not been established. Therefore the purpose of this descriptive anatomic study was to determine the incidence of left common iliac vein compression in an asymptomatic population. METHODS: A retrospective analysis of medical records and helical abdominal computed tomography scans was conducted in 50 consecutive patients evaluated in the emergency department because of abdominal pain. Medical records were reviewed for symptoms and risk factors for deep venous thrombosis, and data were collected and reported according to the Joint Society Reporting Standards for acute lower extremity venous thrombosis. All computed tomography was performed with intravenous contrast medium, and 2-mm to 5-mm axial images were obtained. The minor diameter of the common iliac arteries and veins was measured. The technique of transverse image measurement was validated with multiplanar reconstructions and orthogonal diameter measurements in a subset of subjects. Statistical analysis was performed with the Student t test or Spearman rank correlation. RESULTS: Mean age of subjects without symptoms was 40 years (range, 19-85 years), and 60% (n = 30) were female patients. The mean acute lower extremity venous thrombosis risk factor score was 1.16 +/- 0.23 (range, 0-6; maximum possible score, 28). It was surprising that 24% (n = 12) of patients had greater than 50% compression and 66% (n = 33) had greater than 25% compression. Mean compression of the left common iliac vein was 35.5% (range, -5.6%-74.8%). The structure most often compressing the left common iliac vein against the vertebral body was the right common iliac artery (84%). There was no strong correlation between patient age or common iliac artery size and compression of the left common iliac vein. However, women had greater mean compression of the left common iliac vein (women, 41.2% +/- 3.1%; men, 27.0% +/- 3.0%; P =.003). CONCLUSION: Hemodynamically significant left common iliac vein compression is a frequent anatomic variant in asymptomatic individuals. Therefore compression of the left iliac vein may represent a normal anatomic pattern that has thus far been thought of as a pathologic condition.

Adult↗
PubMed2001

Slit-ventricle syndrome secondary to shunt-induced suture ossification.

OBJECTIVE: To report five children with slit-ventricle syndrome who were found to have increased intracranial pressure despite functioning cerebrospinal fluid shunts. METHODS: Computed tomographic scans demonstrated erosion of the inner table of the cranium and sclerosis of the cranial sutures, particularly the coronal suture. Magnetic resonance imaging scans demonstrated no cerebrospinal fluid over the convexities. The patients were treated with cranial expansion operations that included removal of the sclerotic sutures, which were examined histologically. RESULTS: Postoperatively, symptoms resolved for all children. Sutures were abnormal and contained foci of cartilage and bone within abnormally arranged fibrous tissue. CONCLUSION: We postulate that chronic overdrainage of cerebrospinal fluid via shunts dampens the normal cerebral pressure waves; growth of the calvarium is thus understimulated, and this leads to ossification of the sutures, which become unable to expand to allow normal brain growth. Shunt-induced craniostenosis should be considered for children with symptoms of slit-ventricle syndrome for whom shunts are functional but intracranial pressure is increased. Cranial expansion operations may be more appropriate treatments than subtemporal decompressions for such children, given the diffuseness of the suture pathological features.

Cerebral Ventricles↗
PubMed2003

Spontaneous cerebrospinal fluid rhinorrhea as a presenting symptom of aqueductal stenosis--case report.

A 30-year-old male patient presented with chronic spontaneous cerebrospinal fluid (CSF) rhinorrhea. He had sustained a mild head injury in childhood. Magnetic resonance imaging of the brain showed aqueductal stenosis associated with moderate supratentorial hydrocephalus, and erosion of the cribriform plate. Following insertion of ventriculoperitoneal shunt, the CSF rhinorrhea completely ceased and no direct repair of the CSF fistula was necessary. Long-standing spontaneous CSF rhinorrhea indicates the possibility of concurrent intracranial pathology, such as aqueductal stenosis.

Adult↗
PubMed1989

[An MRI study of the cervical segment of the vertebral artery].

MRI appears to be a very valuable examination to study pathology of the vertebral artery. The examination must include T1 and T2 sequences and scans in three planes. The use of oblique scans allows the planes of section to be adjusted to the course of the artery. MRI can therefore demonstrate abnormalities of flow caused by intrinsic or compressive pathology.

Arterial Occlusive Diseases↗
PubMed2001

Pancreatic ductal myofibroblasts. Proliferative patterns in various pathologic situations.

Myofibroblasts in the periacinar area of the pancreas have been demonstrated to mediate fibrogenesis in pancreatic fibrosis. However, only a few reports have described myofibroblasts in the pancreatic duct. To elucidate the presence of myofibroblasts in the pancreatic ductal wall, we performed an immunohistochemical study, using immunostains for both alpha-smooth muscle actin (alphaSMA) and desmin, and an electron microscopic study on surgically resected pancreatic specimens from 10, 23, 23, and 56 cases of focal pancreatitis (FP), chronic pancreatitis (CP), pancreatic carcinoma (PCa), and carcinoma of the papilla of Vater (VPCa), respectively. All cases showed localized stenosis of the main pancreatic duct by means of preoperative pancreatography. As controls, 20 autopsy cases were studied. alphaSMA-positive and desmin-negative cells existed in the ductal walls of controls and were revealed as myofibroblasts by means of electron microscopy. In six FPs, proliferation of myofibroblasts was observed at the stenotic portion. In VPCas, myofibroblasts mainly proliferated in the pancreatic ductal wall. In CPs and PCas, no myofibroblast proliferation was observed at the stenotic portion. The proliferation of myofibroblasts might occur as a wound healing process in FP, while acting against elevation of intraductal pressure in VPCa. In conclusion, proliferation of myofibroblasts plays an important role in ductal changes in various pathological situations.

Actins↗
PubMed2002

Supravalvar aortic stenosis with supravalvar pulmonary stenosis and peripheral vascular stenoses.

A non-dysmorphic 10 month old female was discovered at surgery to have severe vasculopathy of both the systemic and pulmonary arteries. These findings were confirmed by pathologic examination. Follow-up angiography has confirmed multiple sites of vascular obstruction which appear to be worsening. Angioplasty has only partially relieved these obstructions. The pathology and possible etiology are reviewed.

Aortic Stenosis, Supravalvular↗
PubMed2004

Multidetector CT-generated virtual bronchoscopy: an illustrated review of the potential clinical indications.

Multidetector computed tomography-generated virtual bronchoscopy (VB) is a recent technical development that allows visualisation of the lumen and wall of the trachea and proximal part of the bronchial tree. A dynamic image is produced that resembles what is seen with fibreoptic bronchoscopy (FB). Although the technique has not yet reached daily clinical practice and it can never replace FB, performing VB can be useful in well-defined clinical situations. In this paper, the value and limitations of virtual bronchoscopy will be reviewed, to illustrate the potential role of virtual bronchoscopy in the evaluation of trachea and bronchial tree pathology.

Biopsy↗
PubMed1986

Renal and urinary tract complications following the intravesical instillation of formalin.

The case is reported of a 10-yr-old girl who developed intractable hematuria from hemorrhagic cystitis following chemotherapy for a malignant lymphoma. Following the intravesical instillation of formalin, which controlled the hematuria, she developed oliguria attributable to ureteric stenosis and fibrotic contraction of the renal pelves. Bilateral nephrostomies were constructed, but recurrent pyelonephritis and further renal pelvic obstruction developed. A series of renal biopsies and ultimately bilateral nephrectomy revealed severe, chronic interstitial nephritis, massive renal interstitial accumulation of deposits probably containing Tamm-Horsfall protein and, in the left nephrectomy specimen, a florid interstitial chronic granulomatous inflammatory reaction. Although ureterohydronephrosis has been described by others as a complication of the intravesical instillation of formalin, fibrotic contraction of the upper urinary tract and the florid interstitial nephritis with granulomata as described herein have not previously been reported. It is proposed that vesicoureteric reflux of formalin, perhaps accompanied by intrarenal reflux, caused or contributed to these pathological changes.

Administration, Intravesical↗
PubMed1998

Tuberous breast: a new approach.

The authors make a historical summary of the pathologic condition of tuberous breast and describe a new procedure for its correction. The method involves a periareolar approach, dividing the breast in two portions to disrupt the constricting ring, and making an inferiorly based flap or pedicle, as described and used by the senior author since 1969, with publication in 1973. The main goal is to correct the deformity at a one-stage operation, resulting in a periareolar scar only, without the use of alloplastic elements such as prostheses, mesh, or tissue expanders. The authors emphasize that Brazilian patients prefer having small breasts rather than large ones, even though the procedure allows the implantation of pre- or retromuscular implants through the periareolar incision.

Breast↗
PubMed2004

Sonographic follow-up after visceral artery stenting.

OBJECTIVE: The aim of this study was to evaluate the sonographic features of stents and the flow parameters of the visceral arteries after stent implantation. METHODS: Since 1996, 34 stenoses of the visceral arteries (2 mesenteric, 4 celiac trunk, and 28 renal arteries) in 28 patients have been treated with metallic stent implantation in the Department of Radiology of Szeged Medical University. All these patients were regularly followed sonographically. For the diagnosis of restenosis, previously published criteria were used. RESULTS: All the mesenteric and celiac stents could be visualized, but none of the renal stents were clearly seen sonographically. The flow parameters could be established in all cases. Sonographic examination revealed 1 occlusion, 2 restenoses, and 1 stent displacement. All these abnormalities were confirmed by other imaging modalities. CONCLUSIONS: Sonography is a useful tool in the follow-up of patients after visceral artery stenting. Despite the fact that none of the renal artery stents were visualized directly, the flow parameters could be evaluated, and the pathologic changes were found.

Adult↗
PubMed1991

Popliteal artery entrapment syndrome.

Popliteal artery entrapment syndrome is an uncommon cause of peripheral vascular disease in young fit individuals, presenting as progressive claudication or sudden limb ischaemia. It can also present later in life with insidious symptoms relating to popliteal thrombosis or aneurysm. As a local cause of atherosclerosis in the popliteal artery it is probably under-diagnosed, as clinical and radiological features are subtle and varied. Early diagnosis and surgical division of aberrant muscular relations result in an excellent clinical result. Late surgical treatment with vein grafting is less durable. The disease incidence, clinical features, pathology, investigations, treatment and prognosis are reviewed.

Adolescent↗
PubMed1990

[Comparative study of the diagnostic value of hysterosalpingography and laparoscopy].

A total of 100 women had either hysterosalpingography with watersoluble Verografin or lipidsoluble Jodlipol for the assessment of tubal patency. Of these, all had laparoscopy. Laparoscopy have been shown to be the best test of tubal abnormalities. Hysterosalpingraphy with lipidsoluble contrast medium is poorly informative while the method of investigating the tubal pathology and cannot be used in clinical practice.

Adult↗
PubMed1989

[Lassa fever associated with effusive constrictive pericarditis and bilateral atrioventricular annular constriction: a case report].

A case of Lassa fever associated with effusive constrictive pericarditis and bilateral atrioventricular annular constriction was reported. A 49-year-old man, who had been diagnosed by indirect fluorescent antibody test as the first case of Lassa fever in Japan, was referred to the Hiroo Hospital because of syncope, progressive hepatomegaly, ascites and pericardial effusion in spite of pericardiocentesis and corticosteroid therapy. On admission, his blood pressure was 92/60 mmHg and he had a paradoxical pulse. Two-dimensional echocardiography revealed a localized pericardial effusion adjacent to the right ventricular wall and behind the left ventricular posterior wall. Bilateral atrioventricular annular constriction was also present. On pulsed Doppler echocardiography, the peak inflow velocities of the right and left ventricles increased during atrial systole. Right heart catheterization revealed a mean diastolic pressure gradient of 8 mmHg across the tricuspid valve. After pericardiectomy, a diastolic dip and plateau pattern became evident in the right ventricular pressure tracing, suggesting the presence of residual constriction. However, the atrioventricular annular constriction was no longer evident on two-dimensional echocardiography. This is considered the first reported case of subacute effusive constrictive pericarditis caused by Lassa fever.

Cardiac Catheterization↗