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Results for “Constriction, Pathologic”

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At least 289 records · Page 16Linked to original sources

PubMed1978

[Sclerodystrophy of the sphincter of Oddi (author's transl)].

Among 1,645 biliary operation carried out between 1952 and 1974, the authors count 177 organic stenoses of the Oddi region. They recall the authenticity of chronic odditis, the pathological substratum of which is Oddi sclerodystrophy, a primary and progressive lesion. They emphasise the radiomanodebimetric criteria. The risk of an error of interpretation was 2% in this series. After discussing the etiopathogenesis and the physiopathological consequences of Oddi sclerodystrophy, they discuss the therapeutic choice between sphincterotomy and choledoco-duodenostomy. Temporary gall bladder drainage is only of interest in inflammatory labile manifestations without sclerodystrophy. The interest of diagnosis and initial surgical treatment of the lesion is that the classical post-cholecystectomy syndrome almost disappears.

Ampulla of Vater↗

PubMedDate not supplied

Lymphoma invading the anterior eustachian tube. Temporal bone histopathology of functional tubal obstruction.

The temporal bones of a man with poorly differentiated lymphocytic lymphoma, who had had a bilateral conductive hearing loss and incomplete left-sided facial palsy, were obtained. Sections were prepared for histologic study by staining with hematoxylin and eosin and were examined under the light microscope. The left temporal bone showed marked tumor cell involvement, not only of the lateral part of the cartilaginous portion of the eustachian tube (ET) where the tensor veli palatini muscle had been partially destroyed, but also in the anterior part of the temporal bone. A serous middle ear effusion was present, but the lumen of the ET was unaffected by tumor or inflammation. The pathological findings in the right temporal bone were similar to those in the left, although the cartilaginous part of the ET and its surrounding structures were not available for study. The pathogenesis of otitis media with effusion appeared to be secondary to functional ET obstruction, due to the dysfunction of the tensor veli palatini muscle as a result of the tumor destruction. This case is the first to be reported in which functional ET obstruction, secondary to tumor invasion of the active muscle dilator of the ET, has been histologically confirmed.

Adult↗

PubMed1993

Proximal tubal occlusion by hysterosalpingogram: a role for falloposcopy.

Eight infertility patients with proximal tubal occlusion by HSG and at least one other independent method underwent falloposcopy to evaluate the etiology of uterotubal occlusion. Patency was established in 9 of 12 tubes evaluated. Falloposcopy revealed 5 tubes with multiple or extensive intratubal lesions that would be unsuitable for unilocular tubal resection with subsequent reanastomosis. In addition, 5 tubes were visually normal or had only minor pathological changes (2 of these patients became pregnant). Only 2 of the tubes examined in a single patient would be considered candidates for microsurgical correction at laparotomy. Falloposcopy will become a useful adjunct in the evaluation of the patient with suspected tubal infertility. It provides information regarding the condition of the tubal mucosa that is unavailable by any other technique, adding precision to surgical techniques when they are deemed necessary while directing other patients to assisted reproductive technologies. However, falloposcopy is still in its infancy and data from larger studies are needed.

Adult↗

PubMed1995

State-of-the-art flexible hysteroscopy for office gynecologic evaluation.

STUDY OBJECTIVE: To evaluate office flexible hysteroscopy without anesthesia with regard to pain, inconvenience and cost. DESIGN: A survey of patients to evaluate the level of pain they experienced during office hysteroscopy, and a comparison of costs for these procedures with those of hospital dilatation and curettage. SETTING: Office-based hysteroscopy suite in the outpatient building of a tertiary institution. PATIENTS: Women referred to this institution for gynecologic evaluation between February 1992 and December 1993. INTERVENTION: Diagnostic flexible hysteroscopy without anesthesia, cervical dilatation, or paracervical block. MEASUREMENTS AND MAIN RESULTS: A total of 417 women (mean age 42 yrs, range 16-84 yrs; 78 postmenopausal) were referred for evaluation during the study period. The most common indication for referral was abnormal uterine bleeding (86%). Hysteroscopy could not be completed in 29 women (7%), primarily because of cervical stenosis. Pain ratings obtained from 387 patients were as follows: easily acceptable discomfort, minimal discomfort during procedure, 133 (34.5%); acceptable discomfort, uncomfortable but easily bearable, 86 (22.2%); tolerable discomfort, equivalent to menstrual cramps and spasms, 106 (27.4%); barely tolerable pain, tolerable for short time only, 48 (12.4%); and intolerable pain, severe enough to stop the procedure before completion, 14 (3.6%). A single adverse event, a postprocedure temperature elevation, was easily treated with oral antibiotics. No pathology was identified in 183 (43%) of the women; 95 (22%) had polyps and 90 (21.5%) had fibroid tumors. The average duration of a procedure was 5 minutes. The charge for office hysteroscopy was $475. CONCLUSION: Flexible office hysteroscopy without anesthesia was well tolerated by the majority of the women. In addition, the procedure is far less expensive and time consuming than when it is performed in an operating room. We believe that it is a safe, well-tolerated, and cost-effective procedure of great diagnostic value.

Adolescent↗

PubMed1982

[Radiological biliary tract diagnosis after cholecystectomy (author's transl)].

Fifty-three patients with biliary symptoms were studied at least four years after cholecystectomy by isotope techniques. There was a highly significant correlation between symptoms and disturbances of bile flow, such as dyskinesia or obstruction. There was no correlation with serum enzyme levels such as gamma-GT, alkaline phosphatase, bilirubin or transaminases. Measurements of the diameter of the bile duct on cholangiograms provided no evidence of obstruction up to 15 mm., although a diameter in excess of 10 mm, made obstruction likely. The upper value for "normal" bile flow derived from hilar flow curves of patients without dyskinesia showed a half value period of 27.5 minutes. The disturbances of flow demonstrated by isotope methods in the presence of typical symptoms, and without other pathological findings, indicate a pre-clinical stage of a partly compensated bilio dynamic insufficiency. Where there is no morphological evidence of biliary obstruction, one must assume inflammatory changes round the papilla of Vater; these are frequent even in normal biliary tracts and almost always present after cholecystectomy. Quantitative hepato-biliary scintigraphy is the most reliable method for objective measurement of disturbances of bile flow and make it possible to avoid the vague diagnosis of "post-cholecystectomy syndrome".

Alanine Transaminase↗

PubMedDate not supplied

[Iatrogenic venous pathology and post-radiosurgery swollen arm. Apropos of 100 cases].

Lymphostasis of the upper limb, succeeding the radiosurgical treatment of breast cancer, has been known for some time, along with the clinical entity generally called "swollen arm". Post radiosurgical venous disorders have, however, been much less studied, and so the author's survey is based on a systematic, clinical, and phlebo-lympho-scintigraphical study of 100 case histories. Out of the 100 cases studied, almost 80% presented mixed lympho-venous anomalies, whilst 25% of the cases proved to be "swollen arm" of purely venous origin. Finally the author analyses the different vascular lesions encountered in the follow-up of radio-surgical treatment and the therapeutic conclusions to be drawn from these.

Adult↗

PubMed1996

Extraocular muscle changes in experimental orbital venous stasis: some similarities to Graves' orbitopathy.

BACKGROUND: Graves' orbitopathy (GO) is generally considered to have an autoimmune etiology. Recently, however, it has been hypothesized that orbital venous obstruction may contribute significantly to the clinical manifestations. To determine whether such obstruction could induce histologic and clinical findings consistent with GO, we developed an animal model of orbital venous obstruction by ligating the draining ophthalmic veins of the right eyes of four cats. METHODS: The branches of the ophthalmic veins were isolated and ligated following a lateral orbitotomy. Weekly photographs and echographs were taken of the cats; one cat was killed at each of four time points, namely 1, 2, 3, and 4 weeks after surgery. Histologic stains were applied to isolated orbital tissues to characterize pathologic changes. RESULTS: Clinically, there was onset of marked proptosis, chemosis, and exotropia. Histological findings within the extraocular muscles included activation and the presence of acid mucopolysaccharides 1 week after ligation, increased collagen and the presence of lymphoid cells at 2 weeks after ligation, and persistent interstitial lymphocytic infiltrates the 3rd and 4th weeks after ligation. CONCLUSION: Without evoking a primary orbital inflammation or inducing a systemic autoimmune disease, an animal model has been developed that closely mimics many of the advanced clinical and histologic changes that occur in GO.

Animals↗

PubMed1981

[Postcholecystectomy syndrome: endoscopic and radiological aspects (author's transl)].

542 patients were subjected to ERCP at various periods after cholecystectomy. In this selected patient material there was a 56% incidence of morphological abnormalities in the biliary system, stenosis of the papilla and choledocholithiasis being the most frequent pathological findings. Laboratory examinations proved to be irrelevant with respect to the morphology of the bile ducts. A direct relationship between the clinical symptoms and the surgical procedure was established only in cases presenting with biliary duct stenosis (11% of all cases examined). In the majority of patients the postcholecystectomy complaints were due to incorrect surgical indication or inadequate surgical technique. Postcholecystectomy syndrome can be prevented by more accurate evaluation of the patient prior to and during surgery.

Adult↗

PubMed1984

Pathology of so-called "spontaneous occlusion of the circle of Willis".

Abnormal cerebral vascular networks (Moyamoya blood vessels) are now recognized on cerebral angiograms as collaterals caused by chronic obstruction of the internal carotid arteries due to various conditions. After exclusion of cases in which the etiology is clear, there still remain a considerable number of cases characterized by bilateral involvement of the terminal portions of the internal carotid arteries, and by onset at early childhood due to unknown etiology. These cases should be called "spontaneous occlusion of the circle of Willis." This entity is a part of the "Moyamoya" syndrome. Further investigation is necessary to elucidate the exact cause of this entity.

Adult↗

PubMed1985

Pseudoaneurysm of anterior tibial artery after occlusion from blunt trauma: nonoperative management.

The angiographic finding of occluded isolated tibial artery after blunt trauma to the leg generally is ignored. A case of pseudoaneurysm and arteriovenous fistula that evolved from an occluded anterior tibial artery is presented. The pathology was treated successfully by percutaneous transfemoral placement of Gianturco coils in the tibial artery proximal and distal to the aneurysm. The nonsurgical approach in this patient avoided the risks of anesthesia, blood loss associated with a surgical procedure, the dilemma of the surgical approach in the presence of medial and lateral fasciotomy wounds, and of contamination and destabilization of the comminuted tibia-fibular fractures. This report raises the question of the proper management and followup procedures of occlusions of noncritical arteries found on angiography immediately after trauma.

Adult↗

PubMed1983

[Role of lesions of the major arteries of the head in disorders of hemostasis and the rheologic properties of the blood].

The authors studied the process of platelet and erythrocyte aggregation in blood passing through a special chamber designed to simulate an intact vessel and a vessel which is either stenosed or pathologically convoluted. Aggregate formation was shown to be dramatically increased in simulating a part of a vessel with an altered geometrical pattern of the blood flow, with the increase being more pronounced when the blood from patients with cerebral dyshemias was applied. It was found that in patients with cerebral infarction, the antiaggregate activity of the blood passing through the internal carotid arteries on the affected side was lower than in other sections of the blood stream. The importance of identified regularities in the pathogenesis of cerebrovascular diseases is discussed.

Cerebral Infarction↗

PubMed1990

Parametric assessment of myocardial perfusion during interventional cardiac catheterization by means of X-ray densitometry-short-and long-term results.

X-ray densitometric evaluation of digital subtraction angiocardiograms allows an assessment of myocardial perfusion by means of the parameter 'MEAN RISE TIME' (MRT), defined as the time from the onset of local myocardial contrast medium opacification to the point of maximum opacification. Best results are obtained when the response of that parameter is compared before and after stimulation of coronary flow by papaverine. A prolongation of this parameter, especially after papaverine, was indicative of an impairment of myocardial perfusion, when compared to the results of TL-201 scintigraphy. In 50 patients with single vessel coronary artery disease the results of MRT pre and post papaverine before and after coronary angioplasty, as well as after 6 months were evaluated for 204 post-stenotic regions-of-interest. Before angioplasty papaverine induced a significant prolongation of post-stenotic MRT was measured 2.3 s +/- 0.9 s vs 3.1s +/- 0.8s; p less than 0.01), while after successful angioplasty post-stenotic MRT was measured significantly shorter after stimulation of coronary flow (2.6s +/- 1.0s vs. 1.9s +/- 0.9s; p less than 0.01). This indicated an improvement in myocardial perfusion. Nevertheless, 16/50 patients still presented pathological results of post-stenotic MRT after papaverine, although angioplasty was regarded successful. These patients presented a markedly higher rate of restenosis (14/16 patients after 6 months), a higher rate of dissections at the dilation site and a higher rate of dilated vessels, supplying myocardial areas after a Q-wave myocardial infarction. Thus, these results demonstrate the additional information about the short-and long-term outcome of an angioplasty procedure by densitometric myocardial perfusion analysis.

Absorptiometry, Photon↗

PubMed1989

Natural history of recurrent carotid artery disease.

Controversy exists as to whether early and late recurrent stenosis of the carotid artery represents two distinct types of recurrence or whether it is the same type of lesion detected at different times. Eleven specimens from patients whose carotid arteries were reoperated upon were examined. A temporal sequence was noted: with increasing intervals, the relative presence of areas of myointimal hyperplasia tended to decrease, whereas the relative presence of features of atherosclerosis tended to increase. The clinical data and B-mode ultrasound studies performed from one to 190 months after 210 carotid endarterectomies were reviewed. Twenty-seven carotid arteries (12.9 per cent) exhibited hemodynamically significant restenosis. Three ultrasonographic patterns were described: homogenous soft plaque, homogenous hard plaque and heterogenous plaque. A previous correlation between ultrasonographic and pathologic findings showed the three ultrasound patterns to correlate with myointimal hyperplasia, fibrous atherosclerotic plaque and complex atherosclerotic plaque, respectively. Soft plaques were detected earlier than heterogenous plaques (p less than 0.001). Results from serial studies showed progression of soft plaque to hard or heterogenous plaque, or both. Early and late recurrent lesions are the same type of lesion detected at different intervals. Symptoms of cerebral ischemia are more common at the stage of heterogenous plaque (p = 0.02).

Aged↗

PubMed1986

[Changes in water balance and its correction in patients with stomach cancer].

Blood volume and its components as well as total, extra- and intracellular fluid were measured in 58 gastric cancer patients (including those with concomitant pathology) on admission, preoperatively and in postoperative period. The parameters were compared with those of 17 healthy controls. On admission, water imbalance was relatively more pronounced in cancer patients with concomitant pyloric stenosis. Correction was effected by preoperative infusions of 10.9 l of liquid in uncomplicated cancer for 9.8 days +/- 2.1 and 25.5 l in cases of concomitant pyloric stenosis for 12.1 days +/- 2.4. As a result of these infusions and drug treatment carried out in preoperative period and during the first five postoperative days, water metabolism returned to normal and postoperative clinical course improved.

Blood Volume↗

PubMed1997

[Tendovaginitis stenosans of the thumb in small children (pollex flexus congenitus). The authors' results and review of the literature].

Our personal treatment concept for trigger thumb in children is presented. The guiding symptoms are fixed flexion deformity, (painful) restriction of motion (with a click phenomenon) or persistent extension deformity. Although it is a simple pathology, careful diagnosis is mandatory to rule out other reasons with the same symptoms as trigger thumb, as some of these will lead to severe aesthetic and functional impairment. In 26 patients with persistent symptoms, the A1 ring ligament of the thumb was cut. Free active and passive joint motion was comparable to the opposite side in 92.7% of patients. In 2 cases a secondary operation was necessary because of incomplete A1 ring ligament release. If it is diagnosed and operated on early with a careful operative technique, nowadays no aesthetic or functional impairment should occur in children because of trigger thumb.

Child↗

PubMedDate not supplied

Image processing for the rest of us: the potential utility of inexpensive computerized image analysis in clinical pathology and radiology.

Recent progress in computer technology in both hardware and software, combined with marked cost reductions, have placed quantitatively accurate video densitometry systems within the reach of the individual clinician, biomedical researcher, and community hospital. While much of the attention generated by advances in image processing has focussed on larger scale procedures, such as CAT, chemical shift, and positron emission tomography, important applications can be found for considerably more modest systems. In this article, we discuss three such applications of DUMAS, a personal computer-based imaging system developed by the Image Processing Center at Drexel University. A potential technique for quantifying numbers of estrogen receptors in tumorous breast tissue samples as a predictor of patient responsiveness to hormonal therapy is described first, along with possible sources of error. The second application, also related to clinical pathology and cancer, outlines methods for relating changes in nuclear and cell morphology to the diagnosis of Sezary Cell Syndrome. The utility of binary image filtering methods in the classification of cell types is discussed. The third application involves the development of a semi-automatic procedure for the determination of vessel diameter in arteriograms. A detailed description of the optimization and curve-fitting algorithms is provided along with preliminary test results comparing various approaches. The need for user demand to fuel research and development in small-scale imaging systems is also discussed.

Algorithms↗

PubMed1987

[Testicular function in obstructive azoospermia].

The normal histological findings of the testicles with simultaneous azoospermia according to the former opinion renders greatly probable an obstruction of the seminal ducts. The reversed case of an ascertained obstruction, however, must not necessarily contain also normal histological structures or normal hormone tests. In the obstruction syndrome in 6 out of 23 cases we find changes in the diameter of the tubule, reductions of the spermatogenesis and changes at the interstice. Imprint-cytologically an increase of pathological spermatides at the cost of normal cell developments is shown. According to this the FSH-values are slightly but statistically significantly increased. LH, PRL and testosterone are found within the normal. For the diagnostic delimitation of the obstruction syndrome from a production azoospermia according to these findings the performance of a biopsy of the testicles with histological evaluation and the determination of the FSH-value. The relatively discrete tubular changes alone cannot be used for the explanation of the discrepancy between anatomical and functional results of the operative reconstruction of the seminal ducts.

Adult↗

PubMed1998

[Magnetic resonance sialography. A new diagnostic method for imaging salivary duct patency].

The new technique of non-invasive magnetic resonance (MR) sialography was evaluated for normal and various pathologic conditions of the parotid gland. Ten volunteers and 15 patients with various symptomatic diseases of the parotid gland were tested in the present study. Diseases included pleomorphic adenoma, cystadenolymphoma, carcinoma ex pleomorphic adenoma, ductal carcinoma, adenoid cystic carcinoma, lymphoepithelial carcinoma, non-Hodgkin's lymphoma, sialolithiasis, sialadenitis, Heerfordt's syndrome and congenital duct ectasies. In addition to the usually performed T1 and T2 cross-sectional sequences a heavily weighted T2 sequence (TR 3600, TE 800) was performed and allowed depiction of a fluid-filled parotid duct. Results showed that the main parotid and primary branching ducts were depicted reliably in all normal cases and all patients, except one with sicca syndrome. Pathological conditions such as duct dilatations, duct strictures, obstructing duct calculus and irregular shapes and courses of the ductal system were demonstrable. While X-ray sialography obtained a higher resolution, only MR sialography was able to depict dilated ducts proximal from a complete obstruction, as well as all ductal cysts. Our findings show that MR sialography can be applied successfully to investigations of the parotid gland system. There have been no contraindications or complications to date because MR sialography is non-invasive. The technique will also allow the salivary ducts and lesions to be differentiated from the course of the facial nerve.

Constriction, Pathologic↗