Biomedical subjects
Publications and source records attributed to M K Daskalakis.
We have presented a case of extensive coiling of both common carotid arteries in which surgical reconstruction on the most severely affected side relieved symptoms of cerebrovascular insufficiency. The underlying lesion is believed to be congenital, and surgical correction is recommended in symptomatic patients.
A patient had recurrent middle lobe syndrome and was found to have a congenital accessory cardiac bronchus. Inflammation in its blind pocket was believed to be the underlying cause of recurrence.
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Current concepts of the diagnosis of thoracic outlet compression syndrome are presented together with the surgical experience and results obtained in 45 patients. Conservative therapy with exercise, moist heat and physical therapy is advised in patients with mild, non-disabling symptoms, whereas surgical therapy, resection of the first rib, cervical rib, prolonged transverse process or anomalous first rib is recommended in patients with persistent and disabling symptoms. The complications are minor but some serious events with injury to the subclavian artery, vein and brachial plexus have been reported. Good to excellent results can be expected in over 90% of well-selected cases.
Three patients, with celiac axis compression syndrome who were treated surgically, are presented. All patients improved and remained asymptomatic postoperatively. Angiographic evidence of compression of the celiac axis was present. Patients should be selected for surgery carefully. Those with epigastric postprandial pain, weight loss, angiographic evidence of compression of celiac axis by median arcuate ligament and epigastric bruit are considered suitable.
A case of endobronchial metastasis from breast cancer is presented. The anatomopathological findings suggested the presence of another primary site with metastatic pleural effusion. It is imperative, however, to consider intrathoracic metastasis in patients with breast carcinoma and presenting symptoms such as cough, dyspnea with radiological findings of pulmonary nodules, pneumonitis, atelectasis, pleural effusion and hilar lymphadenopathy. Endobronchial metastasis is extremely rare: it may be the result of carcinomatous emboli through the blood stream or direct invasion of the bronchus by the adjacent carcinomatous lymphadenopathy. Pleural effusion in patients with intrathoracic metastasis does not necessarily evidence pleural metastasis.