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Results for “Constriction, Pathologic”

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At least 469 records · Page 26Linked to original sources

PubMed2000

The use of chorionic villus biopsy catheters for saline infusion sonohysterography.

BACKGROUND: Saline infusion sonohysterography is one of the recent refinements of ultrasonography that has the ability to enhance imaging of the uterine cavity in a safe, inexpensive and expedient manner. The technique can be difficult in women with a stenotic cervical os. This report describes a single-pass technique using chorionic villus sampling (CVS) catheters for saline infusion sonohysterography. METHOD: Saline infusion sonohysterography requires the transcervical passage of a catheter, through which saline is infused. The subsequent distension of the uterine cavity enhances the ability to detect intrauterine pathology with ultrasonography. In women with cervical stenosis, a catheter can be used in place of the more conventional two-pass technique, which requires the use of a uterine sound or probe followed by a conventional catheter. EXPERIENCE: We have used CVS catheters in women with cervical stenosis on 12 occasions. All have been successful and without significant discomfort to the patient. CONCLUSION: The use of CVS catheters for saline infusion sonohysterography in women with cervical stenosis can alleviate the need to remove the cervical probe prior to introduction of the catheter.

Catheterization↗

PubMed2006

[Stroke in Fabry disease. More than a simple stenosis].

The objective is to analyze the updated evidence on the physiopathological mechanisms that can generate cerebrovascular damage in Fabry disease. Fabry disease is the result of the deficiency of alpha-galactosidasa A, which causes pathological storage of glycosphingolipids, in different cells. Associated to renal and cardiac insufficiency, cerebrovascular complications can derive in the death of the patients. During a long time the only reported mechanism was the vascular occlusion by deposit of lipids at endothelial level. At the present time, other mechanisms are postulated. The arrival of enzyme replacement therapy has generated great expectation on the possibility of reversion of these alterations. Although the evidence is scarce and more long-term studies are necessary, some reports demonstrate that after months, the treatment has managed to revert some of the mechanisms involved.

Blood Flow Velocity↗

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↗

PubMed2000

A case of pulmonary arteritis with stenosis of the main pulmonary arteries with positive myeloperoxidase-antineutrophil cytoplasmic autoantibodies.

A 53-year-old woman was referred to our hospital with the main symptoms of productive cough, fever and exertional dyspnoea. Chest X-ray revealed enlargement of the left hilar shadow and cavitary infiltration in the right upper lobe. 99mTechnetium-macroaggregated albumin (99mTc-MAA) perfusion scintigram showed complete hypoperfusion through the entire right lung. A pulmonary angiogram revealed stenotic lesions in the right and left main pulmonary arteries. Right cardiac catheterization showed an elevated right ventricular systolic pressure. There was no evidence of systemic arterial lesions nor vasculitis. The patient was positive for myeloperoxidase (MPO)-antineutrophil cytoplasmic autoantibodies (ANCA) (168 EU). The Mycobacterium avium complex sputum culture was positive. The pulmonary stenotic lesions were surgically resected. The resected pulmonary arterial lesions were pathologically diagnosed as non-specific vasculitis. The cavitary lesion disappeared 6 months after the surgery. Two years after the surgery, although the MPO-ANCA level had decreased to 12 EU, stenosis of the pulmonary arteries reappeared. It is suggested that the patient became positive for MPO-ANCA in association with the Mycobacterium avium complex infection, and that the presence of MPO-ANCA may not be related to the development of pulmonary stenosis of the main pulmonary arteries.

Angiography↗

PubMed2005

Vascular access in hemodialysis: issues, management, and emerging concepts.

This article (1) identifies the types of hemodialysis access, (2) summarizes the clinical standard of care for dialysis access grafts and fistulae, (3) describes the pathology and pathogenesis of venous stenosis in dialysis access grafts and fistulae, (4) tabulates avail-able therapies for hemodialysis vascular access dysfunction and speculates on the rea-sons for the lack of effective therapies, and (5) discusses the development and application of novel therapeutic interventions for this difficult clinical problem. The possibility that dialysis access grafts and fistulae could be the ideal clinical model for testing novel local therapies to block neointimal hyperplasia is discussed.

Arteriovenous Anastomosis↗

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↗

PubMed2004

[Combined video-thoracoscopic, surgical and endovascular treatment in a case of ascites and recurrent bilateral pleural effusion].

Among recurrent pleural effusions a role of remarkable importance is held by those combined with ascitis due to the difficulty of their treatment, even using widely tested techniques. The incidence of such pathology varies from 4% to 6% of patients suffering from cirrhotic pathology, reaching 10% in cases with advanced illnesses. Pleural effusions involve the right emithorax more frequently than the left one, but it can show up bilaterally too. Its etiopathogenesis is tied up to the direct passage of ascitic liquid into the chest and, during the past years, numerous theories have been described to explain this migration. The Authors report the case of a patient with interesting considerations for the diagnostic difficulties and the peculiarity of the treatment performed.

Adult↗

PubMed2005

[Duodenal diverticula and choledocholithiasis in own material].

The detectability of duodenal diverticula (DD), a common duodenal pathology, has been growing with the increasing availability of endoscopic examinations, and especially of endoscopic retrograde cholangio-pancreatography (ERCP). The study is a retrospective analysis of incidence rates of DD and accompanying diseases of bile ducts, liver and pancreas detected by ERCP. We performed 8642 ERCP examinations between 1974 and 2001, which detected DD in 622 (7.2%) patients. Of these, 409 (65.8%) had choledocholithiasis, and 97 (15.6%) liver, gallbladder, bile ducts or pancreatic cancer. In the remaining 106 (17.0%) patients no pathologies requiring surgical intervention were found by radiological examination of bile ducts and pancreatic duct. In 10 (1.6%) patients with DD, caniulation of Vater papilla was not performed due to its anatomical location. Obtained results confirm relationship between DD and choledocholithiasis. It has not been established whether DD predispose to choledocholithiasis by interfering with bile duct emptying and causing bile lithogenicity, or rather that duodenal diverticula are caused by a concrement moved to duodenum by contractions of the gallbladder or sphincter of Oddi.

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↗

PubMed2000

Risk factors for cervical stenosis after loop electrocautery excision procedure.

OBJECTIVE: To assess frequency of and identify risk factors for the development of cervical stenosis after loop electrosurgical excision procedure. METHODS: We reviewed outpatient charts of women treated by loop excision for cervical dysplasia between August 1996 and January 1998 in the colposcopy clinic at Massachusetts General Hospital. One hundred sixty-four women were evaluated for cervical stenosis during follow-up. Stenosis was considered present if manual dilation was required to allow endocervical sampling with an endocervical currette 3 mm wide. Multivariable analysis with stepwise logistic regression was used to evaluate age, parity, tobacco use, hormonal status, use of oral contraceptives, pathology, previous loop excision, performance of additional endocervical excision, and dimensions of excision specimens as predictors of cervical stenosis. RESULTS: The average age was 32 years. Cervical stenosis occurred in ten of 164 women (6%, 95% CI 3%, 11%). Among factors analyzed, previous loop excision and volume of excision specimen were the only independent predictors of stenosis. CONCLUSION: Cervical stenosis correlated with history of loop excision and volume of tissue removed, suggesting that women who have second excisions or large excisions should be counseled that their risk of stenosis might be higher.

Adolescent↗

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↗