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Biomedical subjects

V Mickley

Publications and source records attributed to V Mickley.

15 recordsLinked to original sources
PubMed1992

[Angiographic diagnosis in giant cell arteritis of the arm arteries].

Three women of 66, 68 and 69 years of age presented with chronic arm claudication caused by giant cell arteritic stenoses and occlusions of their arm arteries. In the early stage of the disease, arteriography revealed smooth or undulatory long-segment narrowings. Subsequently, spindle-shaped filiform stenoses developed. They were unilateral in one patient, bilateral-symmetric in another and like a string of beads in the third. In the end, untreated arteritis resulted in smoothly tapered occlusions of the diseased vessels. In patients with symptoms and signs suggestive of giant cell arteritis, typical arteriographic findings may confirm the diagnosis even if histopathological proof is lacking.

Aged↗
PubMed1992

[Stent-supported percutaneous therapy of iliac vein stenosis following operative thrombectomy and placement of a shunt].

Among 15 patients with acute thrombotic disease of pelvic veins who had been submitted to operative thrombectomy and creation of arteriovenous fistula in the groin, 12 presented with stenotic lesions 3 months later. These stenoses were submitted to percutaneous angioplasty. If angioplasty failed, percutaneous placement of a vascular stent (wall stent) was performed immediately (n = 7). Stenting in cross-over-technique proved practicable in all cases. Secondary stenotic disease in the exclusively dilated area was observed in 3/5 cases and was also treated with a wall stent. In one patient with recurrent stenoses who refused stenting, extended thrombosis occurred after occlusion of the AV-fistula. At mid-term PTA was successful in only two cases. Intimal hyperplasia was observed in only one wall stent treated patient. Percutaneous treatment of iliacal stenoses in patients with postthrombotic syndrome may be performed safely under the protective effect of the fistula. With the presented technique, patency of pelvic veins could be restored in 11/12 patients with postoperative significant venous stenoses.

Adult↗
PubMed1992

[Giant cell arteritis of the arteries of the arm. Diagnosis, surgical indications and choice of procedure].

At autopsy, affection of the aortic arch and of the arm arteries is found in about 70% of patients with giant cell arteritis. Symptoms occur in only about 5% of them. Arteriography often shows typical spindle-shaped stenoses or tapered occlusions of the diseased vessels. Arterial stenoses are successfully treated with corticosteroids. In case of chronic occlusion, however, ischemia-induced symptoms may necessitate an operation. Endarterectomy should be preferred to bypass procedures. Subsequent long-term corticosteroid treatment should be instituted in order to treat the underlying disease, and to prevent reocclusions.

Aged↗
PubMed1992

[Bilateral brachial claudication as the initial manifestation of giant cell arteritis. Case report and review of the literature].

A 69-year-old woman presented with bilateral arm claudication caused by segmental occlusions of both brachial arteries. Bilateral retrograde ring-desobliteration resulted in restauration of full pulses. Microscopic examination of the resected specimen revealed giant cell arteritis. No other manifestations of the disease could be detected. At autopsy affection of the aortic arch and of the arm arteries is found in about 70% of patients with giant cell arterities. Symptoms occur in only about 5% of them. Arterial stenoses are successfully treated with corticosteroids. In case of chronic occlusion, however, ischemia-induced symptoms may necessitate an operation. Endarterectomy (i.e. total dissection of the destroyed inner arterial wall layers) should be preferred to bypass procedures. Subsequent long-term corticosteroid therapy should be instituted in order to treat the underlying disease, and to prevent reocclusions.

Aged↗
PubMed1992

[Infrarenal aortic aneurysm in Behçet's disease. Case report and review of the literature].

A 55-year old Turkish male was admitted with a staged aortic rupture requiring emergent surgical resection of the infrarenal aorta. Anamnesis and typical clinical findings (aphthosis, genital ulcers, pustulosis, arthritis) allowed the postoperative diagnosis of Behçet's disease. This etiologically unclear disease rarely occurs in patients from western European countries. Main symptoms are concerning the skin, the mucous membranes, and the eyes. The vascular system may occasionally be involved. In patients presenting with inflammatory arterial aneurysms, arterial or venous occlusions, careful search for the main symptoms will provide adequate diagnosis. Acute arterial affections, especially aneurysms, often urge surgical treatment. Until now, there is no effective medical prophylaxis.

Aorta, Abdominal↗
PubMed1991

[Arterial lesions following radiotherapy].

From 1980 to 1990 twelve patients with vascular lesions attributable to irradiation were treated. The time interval between radiotherapy because of malignancy and onset of symptoms due to radiation-induced atherosclerosis was on an average 7 years (1 month-29 years). A typical morphological finding at angiography was the well-localised vascular lesion in the previous radiation area, its localisation clearly distinguishable from typical atherosclerotic lesions. 10 patients had other radiation damage with involvement of the skin and perivascular tissue frequently necessitating an extra-anatomic reconstruction (n = 6). 4 patients had an anatomical reconstruction, one had a PTA, one was treated conservatively. Due to absence of multifocal arteriosclerotic lesions, long-term results of vascular reconstruction are good and will certainly contribute to further improvement of life quality after curative therapy for malignant disease.

Adult↗
PubMed1991

[Lumbar spinal nerve root compression syndrome as an atypical initial manifestation of a rare vascular disease].

A 55 year old male Turkish patient developed L3/L4 root compression caused by a retroperitoneal hematoma after covered perforation of the infrarenal aorta. The aneurysm was resected and a tube interposition made. For more than 20 years the patient has suffered from oral and scrotal ulcers. These signs led to the diagnosis of Behçet's disease. A review of the literature revealed 200 arterial complications (aneurysms and occlusions) in 105 patients with Behçet's disease, only 19 of them had aneurysms of the infrarenal aorta.

Aortic Rupture↗
PubMed1991

[Continuous intestinal suture with polydioxanone].

Within five years a total of 264 anastomoses were performed on 241 patients in a continuous extramucosal single-layer end-on suture technique with polydioxanone. In 133 small bowel, and 131 colonic anastomoses there were no leakages as the only complications attributable to the procedure. Both anastomotic failures occurred after colonic resections, for a 1.5% dehiscence rate. Small bowel anastomoses healed without complications.

Anastomosis, Surgical↗
PubMed1990

[Choledocholithiasis: risk factors and their significance for pre- and intraoperative diagnosis].

In 19% of the cholecystectomies done for acute cholecystitis, cholangitis and/or jaundice, an operative cholangiogram could not be obtained, usually because of considerable local inflammatory changes. This was the case in only 1.7% of the operations for uncomplicated cholelithiasis. Surprisingly high was the 31% rate of choledocholithiasis among the patients with complicated cholelithiasis, when compared to the 8% rate for operations in the complication-free interval. If a cholangiogram could not be obtained, exploration of the choledochal duct also was renounced. So patients with residual choledochal stones had to be expected, and in fact became symptomatically within the five years of follow-up.

Adult↗
PubMed1989

[Actinomycosis of the bladder].

A palpable tumour was discovered in the left lower abdomen of a 66-year-old woman with uncharacteristic lower-abdominal pain and treatment-resistant pollakisuria and stress incontinence. On ultrasound examination the tumour was about 6.0 x 2.5 x 2.5 cm in size and was located between bladder roof and anterior abdominal wall. Ultrasound-guided fine-needle biopsy failed to produce any cytologically interpretable material, and there was no bacterial growth from the aspirate. All clinical and biochemical findings were normal, except for a raised blood-sedimentation rate (15/43 mm). The tumour, completely removed at laparotomy, was diagnosed to be actinomycosis of the bladder. No long-term postoperative antibiotic treatment was undertaken. Nine months after the operation the patient was without symptoms and there were no abnormal clinical findings.

Actinomycosis↗
PubMed1989

[The prevalence and significance of pseudodiverticulosis of the small intestine].

Diverticula of the small intestine were found in four among 358 consecutive major abdominal surgical procedures (1.1%). The prevalence rate was 4% among patients over the age of 70 years. All of the discovered diverticula were located in the proximal jejunum. Two patients had single, two had multiple diverticula. All patients were women (aged 73, 78, 81 and 86 years). In three the finding was by chance: in one the operation had been done for a perforating duodenal ulcer, in two because of ileus. The 86-year-old woman was operated for lower intestinal bleeding. During the operation a solitary diverticulum, the cause of the bleeding, was excised.

Age Factors↗
PubMed1989

[Jejunal pseudo-diverticular hemorrhage].

Within six months we observed two elderly female patients with intestinal bleeding from jejunal pseudodiverticula. A 91-year-old woman with multiple pseudodiverticula was treated conservatively. In the other, aged 86, persistent intensive bleeding had to be halted by resection of the solitary pseudodiverticulum. Both very elderly women were discharged from hospital fully recovered. The two cases are discussed and the literature is reviewed.

Aged↗
PubMed1987

The rise of blood sugar as an additional parameter in traumatic shock.

Besides the known cardiovascular effects of hemorrhagic shock, regular metabolic consequences can be demonstrated in the rabbit: 1. The rise in blood sugar in hemorrhagic shock increases with the amount of blood withdrawn per unit of time. 2. The characteristic rise in blood sugar lasts longer than the phase of the partial exsanguination. 3. In traumatic shock, the rise in blood sugar indicates the degree of severity of the injury earlier than the fall in blood pressure does. The rise in blood sugar is attributable to a reflex increase in glycogenolysis due to catecholamine secretion elicited via baroreceptors in hemorrhagic shock. For the pronounced rise in blood sugar in traumatic shock, an additional receptor is postulated. Supplementary investigation of the blood sugar may possibly enable the extent of the injury to be diagnosed earlier in traumatic shock, and the negative sequelae may be reduced by timely, adequate therapy.

Animals↗