Calcific constrictive pericarditis (concretio cordis).
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Biomedical subjects
Publications and source records attributed to M N Krishnan.
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We describe a novel method that allows bioptome-assisted delivery of multiple Gianturco coils simultaneously for occlusion of the large patent ductus arteriosus (PDA). Two or more coils were intertwined at one end and held by a bioptome (5.2 Fr) and pulled into a short introducer. The coils were then deployed in the PDA via a long sheath (7-11 Fr) previously placed across the duct via the femoral vein. Twelve patients (6 months to 64 years; median, 10.5 years) with large PDAs (4.7 +/- 1.3 mm; range, 3.1-8.4 mm; PA mean pressure, 40 +/- 17 mm Hg; pulse pressure 63 +/- 18 mm Hg) underwent bioptome-assisted occlusion with multiple coils at our institutions. The procedure was uneventful in nine patients (fluoroscopy time, 6-23 min) and prolonged in three patients (fluoroscopy time, 26, 72, and 120 min) because of dislodgment of the coil mass and embolization of an additional coil. Successful coil deployment was feasible in all patients. Three patients required repeat coil deployment for flow elimination (hemolysis occurred in two). Flow elimination was demonstrated on the last follow-up evaluation in all except two patients. One infant has developed significant left pulmonary artery stenosis. Bioptome-assisted PDA occlusion using multiple coils delivered simultaneously may be a promising alternative to devices for transcatheter closure of large PDAs. Cathet Cardiovasc Intervent 2001;54:95-100.
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Acute cytomegalovirus infection was associated with two episodes of morbilliform eruption in a patient receiving ampicillin therapy. Shortly after the eruption cleared, the patient died. Histologic examination of the skin indicated a cytomegalovirus infection of the vascular endothelium with luminal obliteration, stasis, vasculitis, and thrombus formation.
Squamous cell carcinoma of the stomach is a rare, unusual lesion which tends to occur at a somewhat earlier age than adenocarcinoma. Grossly and radiologically the tumor is indistinguishable from adenocarcinoma and may involve any portion of the stomach. Although the pathogenesis of this lesion remains unclear, most authors favor the "metaplastic theory" for the development of the tumor. In this case it is felt that the tumor probably arose from gastric squamous mucosa present congenitally in the lesser curvature.
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