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Results for “Constriction, Pathologic”

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At least 379 records · Page 21Linked to original sources

PubMed1998

Failure of a gastrocnemius muscle flap due to an isolated high-grade stenosis of the sural artery.

The gastrocnemius muscle is highly reliable for flap coverage of defects of the knee or upper third of the leg. Pathology or injury to its dominant arterial pedicle is rare, so preoperative testing is usually not required when distal pulses are present. In this case, an unsuspected high-grade stenosis of the origin of the sural artery was the cause of failure of the flap and made it necessary to use a free flap for salvage. This case raises questions as to the need for preoperative or intraoperative assessment of patency and/or perfusion pressure of the flap vascular supply.

Arteries↗

PubMed1985

Studies of pathologic vasoconstriction (vasospasm) in microvascular surgery.

Characterization and resolution of microvascular spasm were investigated in 170 studies with the use of tail or femoral arteries of the rat. Topical epinephrine reliably produced vasospasm and topical vasodilators which included 2% and 20% lidocaine (Xylocaine) and 0.75% bupivacaine (Marcaine) were applied to resolve the vasoconstriction. Extensive vessel dissection was necessary to obtain significant resolution of vasospasm, and adventitial stripping was associated with even more impressive results. Local anesthetics appear to have a concentration dependent ability to resolve vasospasm, and 20% Xylocaine is the most effective agent yet studied.

Anesthetics, Local↗

PubMed1980

[Feasibility of ultrasonic dopplerography in determination of the pathogenesis of transient cerebral circulatory disorders].

For specifying the pathogenesis of transient cerebrovascular disorders and the importance of occlusive lesions in the major cerebral vessels in this form of cerebrovascular pathology a new simple and safe method--ultrasonic dopplerography--was used in 87 patients. Subsequent cerebral angiography showed that the comparative reliability of this method in occlusions of the carotid and vertebral arteries reached 92.3%, and in their stenoses 76.6%. This makes it possible to recommend the ultrasonic dopplerography method for broad use in the conditions of both polyclinics and hospitals for examining patients with signs of transient cerebrovascular insufficiency.

Adult↗

PubMed1981

Umbilical circulation--physiology and pathology.

1. The umbilical circulation under physiological conditions is protected by the amniotic fluid. This protective mechanism of the amniotic fluid may be disturbed artificially or spontaneously by the rupture of the membranes. 2. Umbilical cord compression is of no harm to the fetus when it is mild, since the fetus possesses a circulatory buffer system when umbilical blood flow is in a physiological range. However, severe reduction of umbilical blood flow may lead to fetal hypoxia. 3. Chronic or repetitive acute fetal hypoxia leads to deterioration of fetal circulation and umbilical blood flow. This can be recognized by the obstetrician during labor based on fetal heart rate patterns.

Animals↗

PubMed2001

Use of digital subtraction fluoroscopy to diagnose radiolucent aspirated foreign bodies in infants and children.

OBJECTIVES: Most tracheobronchial foreign bodies in children are radiolucent, and accurate diagnosis of such foreign bodies is not always easy. This can result in delay of diagnosis or misdiagnosis of foreign body aspiration. We report the usefulness and pitfalls of use of digital subtraction fluoroscopy (DSF) to diagnose radiolucent aspirated foreign bodies in infants. METHODS: From 1991 through 1999, DSF was conducted for a total of 19 patients (ranged from 11 months to 4 years and 7 months in age (mean 1.8+/-0.9 years)) who were suspected to have radiolucent aspirated foreign bodies. Since DSF revealed abnormal findings in a trachea or main bronchus in 18 cases, inspection was performed for foreign body bronchofiberscopically. In the one remaining case, no abnormality was recognized on DSF, but since the symptoms at the time of onset strongly suggested aspirated foreign body, bronchofiberscopy was also performed. RESULTS: Foreign body was verified bronchoscopically in 13 of 19 cases, and all 13 (100%) had abnormal findings on DSF, including obstruction of the trachea in two, obstruction of the bronchial lumen in nine, and indistinct visualization of the bronchial lumen in two. Bronchial stenosis was verified bronchoscopically in five of the remaining six cases, including mucus plug in three, granuloma in one and mucosal edema in one case. All five patients (100%) had abnormal findings on DSF, including obstruction of the bronchial lumen in four and indistinct visualization of the bronchial lumen in one. In the one remaining patient with normal findings of DSF, no foreign body or pathological bronchial changes were noted. CONCLUSIONS: DSF was very sensitive in the diagnosis of foreign body aspiration and stenotic changes in the bronchial lumen. However, its diagnostic specificity for aspirated foreign body itself was not high (17%). Therefore, when abnormalities are found on DSF, we recommend to perform flexible bronchofiberscopy initially under general anesthesia via a tracheal tube. When a foreign body is verified, rigid ventilation bronchoscopy is successively performed to retrieve the foreign body.

Bronchi↗

PubMed1997

[Intestinal stenosis during ulceronecrotizing enterocolitis].

BACKGROUND: Intestinal stenosis following necrotizing enterocolitis (NE) occurred both in surgically-treated neonates after perforation, distal to an enterostomy and in medically-treated patients developing symptoms of obstruction. It has been proposed to detect stenosis by contrast enema before refeeding in those medically-treated patients. The aim of this study was to compare delay, clinical and pathological characteristics of surgical and medical patients, both after occlusion and prospective contrast studies. PATIENTS AND METHODS: Fifteen patients out of 50 with NE observed from 1984 to 1994 developed one or several intestinal stenosis. Diagnosis of NE was based on usual clinical signs, X-ray pneumatosis (43 to 50) and/or perforation in 16 cases. Among these 16 surgical patients, 12 survived the initial perforation. Among the 34 medical patients, 11 were seen before 1989 and did not have contrast studies before refeeding; 23 seen after 1989 had a contrast enema before. RESULTS: One or several stenosis occurred in four out of 12 surgical patients, four out of 11 medical patients without prospective contrast studies (one of them died from sepsis) and seven out of the 23 of the prospective group. On the whole, 26 stenosis occurred in 15 neonates: ten to the right colon, five to the transverse and 11 to the left colon. One ileal stenosis followed enterostomy. Delay of stenosis development was comparable in the three groups (between 3 weeks and 3 months). Pathologic examination showed similar lesions in the three groups (fibrosis 15, edema nine to 15 and chronic inflammation 12 to 15). CONCLUSION: Among 46 neonates who survived the initial period, 15 developed stenosis, a 30% proportion similar in patients operated on for perforation or in medically-treated patients whose diagnosis was made after occlusion or after contrast enema as well. These results suggest that systematic stenosis detection by contrast enema may avoid complications and permit programmed one-stage surgery.

Constriction, Pathologic↗

PubMed1981

[Examination of the extracranial carotid artery with a high resolution B scanner. A comparison with carotid angiography (author's transl)].

Patients with cerebro-vascular insufficiency in stages I to IV had their extracranial carotid arteries examined with a high resolution real time ultrasound scanner. In 227 cases, carotid angiograms were available for comparison. Provided good image quality was obtained, sonography was able to distinguish with certainty between a normal and a pathological narrowed vascular lumen. Mural changes could be shown down to 0.5 mm. Under suitable conditions it was possible to differentiate between smooth and irregular plaques. Occasionally, ulcers were visible. High resolutions real time sonography is the only noninvasive method which provides information on the appearance and movements of vascular walls and of changes within these. It is possible to detect atherosclerotic changes at an early stage without risk, and to observe their development.

Arteriosclerosis↗

PubMed1984

[B-image sonography of carotid bifurcation].

The main purpose of noninvasive high-resolution B-mode sonography of the extracranial carotid artery is to detect clinically relevant arteriosclerotic lesions. That is the reason why reproducible parameters are needed for the description of normal and pathological echo patterns of the vascular lumen and the vascular wall. From an experimental evaluation of 100 carotid specimens examined with a high resolution real time scanner a list of definitions for sonomorphologic parameters is derived. These parameters refer to the clinical importance of luminal and intramural changes. Because of its high sensitivity for even minimal arteriosclerotic lesions, B-mode sonography is a useful method for clinical and epidemiological studies of extracranial carotid disease.

Brain Ischemia↗

PubMed2003

Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery--diagnosis by capsule endoscopy: a report of two cases.

Peri-anastomotic ulcerations may occur in patients with previous abdominal surgery. They may present only with obscure GI bleeding. We report two cases in whom capsule endoscopy identified postsurgical stenoses with ulcers as the cause of obscure GI bleeding. Case 1. A 57-year-old male operated on in 1970 for a post-traumatic diaphragm hernia followed by displacement of the caecum in the upper left abdominal quadrant. Case 2. A 32-year-old female with a salpingectomy for tuberculosis (1978) followed by segmental ileal resection for intestinal obstruction. Both patients had undergone extensive work-up including bidirectional endoscopies and enteroclysis with negative results. Capsule endoscopy with the GIVEN diagnostic system was done. Ileal stenoses with mucosal ulcers in dilated prestenotic loops were observed in both cases. The capsule was retained at the stenosis site, requiring ileal resection and anastomosis. Pathology reports showed mucosal ulcers. In case 2, tuberculosis was ruled out by tissue and faecal polymerase chain reaction and culture. Ileal stenoses with prestenotic ulcerations causing GI bleeding may occur in patients with previous abdominal surgery. Capsule endoscopy may clarify the diagnosis and shorten the diagnostic work-up. However, these patients should be warned that capsule retention requiring surgery might occur.

Adult↗

PubMed1984

Cerebral hyperperfusion after carotid endarterectomy: a cause of cerebral hemorrhage.

Correction of a very high grade carotid stenosis by endarterectomy in a normotensive man was followed by the development of severe unilateral head, eye, and face pain, seizures, and on the 6th day a fatal intracerebral hemorrhage. Autopsy revealed changes in the cerebral hemisphere ipsilateral to the endarterectomy that resembled the changes seen in malignant hypertension, whereas the opposite hemisphere was normal. These changes included hypercellularity and edema of arterial and arteriolar walls, with necrosis, extravasation of erythrocytes, and exudation of fibrin. We propose that the clinical and pathological features in this case were due to relative hyperperfusion of a cerebral hemisphere in which autoregulation had been impaired because of preoperative chronic hypoperfusion with chronic maximal dilatation of its blood vessels. This state of relative hyperperfusion is probably similar to the normal perfusion pressure breakthrough that occasionally occurs after the resection of cerebral arteriovenous malformations. It is similar to the breakthrough perfusion that occurs in severely hypertensive patients and results in hypertensive encephalopathy.

Arterioles↗

PubMed1986

Clinicopathologic correlation in postendarterectomy recurrent stenosis. A case report and bibliographic review.

The case history of a 60-year-old man with symptomatic recurrent stenosis of the left carotid artery 20 years after carotid endarterectomy is presented. At reoperation (repeat endarterectomy and venous patch angioplasty) the lumen was found to be reduced by 60% and histopathologic study revealed atheromatosis with organizing mural thrombus. The case is discussed in the context of the recent literature concerning restenosis, the reported frequency of which varies depending on the size of the population studied and the method of follow-up, with noninvasive studies revealing that restenosis is more commonly asymptomatic than symptomatic. Early simple fibrous restenosis differs histologically from the more complex, frankly atherosclerotic late restenosis and appears to reproduce the original pathologic condition of the carotid bifurcation; as in the original lesions hemodynamic conditions probably play a major etiologic role in the formation of the restenoses. The most important clinical factor in restenosis is continued cigarette smoking. In the majority of the studies reviewed, more than half of the patients with recurrent disease presented with symptoms referable to the site of the original operation. An argument in favor of routine vein patching during the primary procedure to attempt to prevent restenosis is presented.

Adult↗

PubMed1999

The impact of urinary extravasation after radical retropubic prostatectomy on urinary incontinence and anastomotic strictures.

OBJECTIVE: The aim of this study was to determine the relevance of urinary extravasation as proven by cystogram 18 days after radical retropubic prostatectomy for the degree of postoperative urinary incontinence and the incidence of anastomotic strictures. PATIENTS AND METHODS: A total of 225 patients underwent radical retropubic prostatectomy at our institution during a 30-month period, 215 of whom received a cystogram a mean 18 days following surgery. Three and 6 months after surgery these 215 patients were evaluated regarding the degree of urinary incontinence and the presence of anastomotic strictures. RESULTS: The cystogram demonstrated a watertight anastomosis in 89% (n = 195; group I), the remaining 11% (n = 24; group II) showed urine extravasation. Groups I and II were comparable with respect to age, preoperative serum levels of prostate-specific antigen (PSA), tumor grade and pathological staging. Six months after surgery, there was no statistically significant (p > 0.05) difference between both groups regarding the degree of urinary incontinence and the presence of anastomotic strictures. CONCLUSIONS: The presence of urine extravasation 18 days after radical retropubic prostatectomy has no impact on postoperative urinary incontinence and the incidence of anastomotic strictures. Based on these data it is not indicated to leave the catheter in situ beyond that point of time.

Aged↗

PubMed1995

Dorsal spinal venous occlusion in the rat.

Occlusion of the major components of the spinal venous system is usually associated with spinal arteriovenous malformations or systemic thrombophlebitis. Although spinal venous system dysfunction has been implicated in compressive cord syndromes, myelopathies from decompression sickness, and spinal cord trauma, its pathophysiology remains unclear. To characterize disorders associated with spinal venous occlusion, we developed a model in the rat produced by focally coagulating the dorsal spinal vein transdurally at the T7 and T10 vertebral levels. Following such occlusion, venous stasis, sludging and perivascular hemorrhages in the small venous branches were observed. By 1 week postocclusion, animals developed hindlimb paralysis from which they partially recovered over time. Histologic examination in the acute phase disclosed tissue necrosis, edema, and hemorrhages predominantly in the dorsal aspect of the spinal cord. This was gradually replaced by an intense macrophagic infiltration and the partial formation of a cystic cavity by 1 month. These findings indicate that dorsal spinal vein occlusion in the rat causes significant neurologic and pathologic alterations. We conclude that this procedure produces a relevant animal model for the study of the pathophysiology of spinal venous occlusion, and it allows the characterization of its effects on spinal cord blood flow, the blood-spinal cord barrier, and the development of edema independent of cord compression. Our findings in this model provide an insight into one of the mechanisms of injury extension in spinal cord trauma and other disorders associated with spinal venous dysfunction.

Animals↗

PubMed1993

Acute pancreatitis is not a cause of chronic pancreatitis in the absence of residual duct strictures.

It has been shown that intraductal injections of bile salts into the bile-pancreatic ducts of dogs or rats were immediately followed by acute hemorrhagic pancreatitis and, some months later, by persisting chronic pancreatitis. The study described in this article was designed to test the assumption that these chronic lesions were due to ductal strictures secondary to the toxic effect of bile salts. The bile-pancreatic ducts of 100 rats were injected with 0.2 ml of a solution containing 4 microM Na taurodeoxycholate and 0.2 microM trypsin. The 66 survivors were killed at intervals from 1 day to 2 months following the induction of acute pancreatitis. Four to six sections were done in the first series, and serial 15-micron sections of the entire pancreas were taken from rats surviving 2 months. These showed that from the sixth day on, the largest ducts draining pathological areas were obstructed by fibrosis. Distal to this obstruction, intralobular ducts were dilated and their epithelia flattened or atrophied. Acini were atrophied and replaced by peri- and intralobular fibrosis. Lesions were limited to areas drained by obstructed ducts, with the rest of the parenchyma being normal. We conclude that in experimental animals, as in human beings, chronic lesions that persist after acute pancreatitis are due to duct obstruction, not to acinar necrosis.

Acute Disease↗

PubMed1988

[Treatment of hydronephrosis caused by obstruction of the pyeloureteral junction diagnosed before birth].

From 1981 to 1987, the authors observed 69 patients with ureteropelvic junction obstruction diagnosed by antenatal ultrasound, representing a total of 77 pathological renal units. Seventy renal units were treated by ureteropelvic resection, one renal unit returned to normal without treatment. There were 3 primary nephrectomies and 3 secondary nephrectomies for non-improvement after percutaneous nephrostomy. An early antenatal surgical management of ureteropelvic obstruction after antenatal ultrasound diagnosis does not seem to give better results than when diagnosis is made at a later stage. The interest of the antenatal diagnosis is not as important as for other uropathies such as urecterocele, mega-ureter or posterior urethral valves.

Constriction, Pathologic↗

PubMedDate not supplied

[Hypophysis compression syndrome in the sella turcica: mechanisms of development, pathology].

Intrasellar hypertension--a phenomenon of the hypophysis compression in the sella turcica-was described 13 years ago. It develops under stressor conditions and is probably one of the causes of frequent in critical situations (shock, collapse, coma, etc.) episodes of acute hypophyseo-adrenal failure. Intrasellar hypertension morphologically manifests by the volume unbalance between a suddenly increasing, 1.5-2 times, hypophysis (due to adenocyte hypertrophy, hyperemia, colloid retention) on the one hand, and its rigid capsule and sella turcica, on the other. Extrahypophyseal factors (high liquid and venous pressure) may take part in developing of this phenomenon due to hypophysis squeezing from outside.

Blood Pressure↗

PubMed1994

The cleavage plane in semi-closed endarterectomy of the superficial femoral artery: a histologic study.

PURPOSE: The purpose of this study was to determine the cleavage plane in semiclosed endarterectomy of the superficial femoral artery, a histologic study of endarterectomy cores of 10 consecutive patients was performed. Superficial femoral artery occlusive disease consisted of multiple stenoses in one and an occlusion in the other cases. METHODS: Microscopic paraffin cross-sections were made every half centimeter of the endarterectomy core. The sections were stained with hematoxylin-eosin and with elastica van Gieson. Microscopic studies were conducted of a total of 484 sections. Intima, internal elastic membrane, media, external elastic membrane, and adventitia were identified, if present. RESULTS: When the procedure of separating the diseased intima from the remainder of the arterial wall was commenced, the cleavage plane was located between the internal elastic membrane and the media in most cases. In two cases the cleavage plane was located inside the intima, and in one case parts of the media were removed as well. During passage of the ring stripper through the artery, the location of the cleavage plane changes and extends into the media. In one patient a residual stenosis was located in the segment of the core in which only the intima and internal elastic membrane were removed. In two patients the endarterectomy core contained parts of the external plastic membrane as well. During passage of the ring stripper through the artery, the location of the cleavage plane changes. In some segments the media is left intact, whereas in other segments the media is partially or totally removed. The reason for the variability of the cleavage plane rests in the nature of the pathologic behavior of the atheroma. The tissue necrosis that is part of the atheromatous complex frequently dips beyond the internal elastic membrane into the media and even into the external elastic membrane and adventitia. CONCLUSIONS: The question remains as to whether the location of the cleavage plane has an influence on the long-term results of endarterectomy. Long-term follow-up studies are required to supply us with the answer.

Aged↗

PubMed2003

[Vascular manifestation of von Recklinghausen neurofibromatosis: case report of venous dysplasia].

We present the case report of a patient with neurofibromatosis and regional dysmorphism in the superficial femoral vein. Colour coded duplex sonography revealed an incidental finding: thickening of a short portion of the vein wall with calcification. This unusual finding strongly suggests a causal relationship. Pathological processes in the arteries have often been described in patients with von Recklinghausen's disease (neurofibromatosis). Dysplastic and hyperplastic reactions of the intramural nerve tissues and the smooth muscle elements in the vascular wall have been observed. This leads to the formation of aneurysms and arteriovenous fistulas and to stenosing processes in the peripheral, visceral and cerebral arteries. However, involvement of the veins in type 1 von Recklinghausen's neurofibromatosis has only been reported in old histopathological studies of medium-sized and small vessels.

Arteriovenous Malformations↗