Takayasu's arteritis. A worldwide entity.
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Biomedical subjects
Publications and source records attributed to A Lande.
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The management of 23 patients with traumatic pseudoaneurysms is presented. A pulsatile mass associated with pain was the usual presentation. Hypertension and hypovolemic shock from rupture are uncommon presentations but potential hazards of this lesion. Twenty-one pseudoaaeurysms were treated surgically. Resection with end-to-end anastomosis (eight patients), with graft replacement (one patient), with lateral repair (seven patients) was done. Hypothermia with circulatory arrest and external Dacron shunt were used to prevent visceral ischemia during high aortic occlusion. There were no mortalities or significant postoperative complications.
We report an aortographic-pathological correlation in a patient with Takayasu arteritis. The inflammatory activity in Takayasu arteritis gradually subsides and accordingly, the histological appearance goes through a cycle of changes, ranging from acute florid inflammation to an old scarred vessel. At gross pathological inspection, the aortic intima frequently shows longitudinal wrinkling and tree-barking indistinguishable from syphilitic aortitis. In other instances, secondary atherosclerosis totally obscures the underlying changes of aortitis. In such instances, close search at various levels of the aorta is likely to uncover persistent foci of arteritis and thereby permit identification of the pathological changes as secondary to previous aortitis.
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Most adults with acute bacterial renal infection demonstrate no roentgen abnormality in the acute stage and recuperate without significant functional or morphological renal abnormality. We report the initial and long-term findings in a virulent form of acute bacterial nephritis caused by gram-negative organisms and predominantly in patients with diabetes and associated septicemia. The findings of a small, poorly functioning symmetrically scarred kidney with significant caliceal distortion and the associated angiographic abnormalities are presented for the first time in the long-term followup of this disease.
Splenic arteriography was performed in 14 patients immediately following antecedent splenoportography. Arteriographic evidence of splenic hematoma was demonstrated in 3 patients while in the remaining 11, no arteriographic abnormalities were detected.
The arteriographic and clinical spectrum of Takayasu's arteritis in a series of 23 cases is reviewed. The incidence of the disease appears to be much higher than is generally suspected. Although it primarily afflicts young women, children are frequently affected. Two clinical stages of the disease are recognized: an early systemic and a late occlusive phase. The signs and symptoms of both stages are protean and variable. The pathological appearance varies with the activity and duration of the disease. Total aortography is of primary diagnostic importance in demonstrating the characteristic appearance of the diseased aorta.
The chest roentgenographic findings in Takayasu's arteritis include widening of the ascending aorta, contour irregularities of the descending aorta, arotic calcifications, pulmonary arterial changes, rib notching, and hilar lymphadenopathy. The single most important diagnostic sign is a segmental calcification outlining a localized or diffuse narrowing of the aorta. The other signs may be suspicious or suggestive, but the diagnostic accuracy increases when several findings are present simultaneously.
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The Authors report their experience with the use of the Olympus Endoloop HX-20L for the prevention of haemorrhages after endoscopic polypectomy. They emphasize the utility of this therapeutic device that will find its right application only in a well selected group of patients.
This is the sixth report in the English literature of survival following repair of a supraceliac aortic traumatic aneurysm secondary to penetrating injury. Symptoms, (12 months after a stab wound of the flank), led to discovery of an aneurysm 15 cm in diameter, originating from the left side of the supraceliac aorta. Repair was accomplished with a temporary thoracoabdominal bypass shunt graft of woven Dacron.
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