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Results for “Constriction, Pathologic”

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At least 163 records · Page 9Linked to original sources

PubMed1992

[Transesophageal echocardiography for evaluation of the left coronary artery].

The aim of the study was to evaluate the clinical usefulness of transesophageal echocardiography in the imaging of the left main coronary artery. The group tested--consisted of 26 patients with angina pectoris and 8 controls. The identification and adequate images of the left main coronary artery were obtained in 33 of 34 (97%) patients. In 5 of 26 patients with angina pectoris we observed stenosis of the left main coronary artery. The diameter stenosis of the lesion was judged to be greater than 50%. In addition, we tried to asses Doppler-derived parameters of blood flow. We have demonstrated that the pulsed Doppler study of the left main coronary artery is feasible. Comparison of patients with angina pectoris with the control group showed lower systolic flow velocities (35 +/- 10 cm/s vs. 55 +/- 15 cm/s) and slightly higher diastolic flow velocities (75 +/- 20 cm/s vs. 70 +/- 10 cm/s). This transesophageal examination holds promise for detecting pathologic vascular status. Although the sensitivity and specificity of this findings cannot be determined by our study, we believe that transesophageal echocardiography can provide a reference for the evaluation of patients with known or suspected ischemic heart disease. Further studies including larger groups of patients are recommended.

Aged↗

PubMed1990

[Popliteal vein entrapment, popliteal cyst, desmoid tumor and fabella syndrome].

The popliteal fossa is a relatively small, muscle-bound strategic anatomical area where is found, on the posterior aspect of the knee, a vasculonervous pedicle and where both vascular and pseudovascular disease may develop, the latter originating from wall-constituting parts. Among non-typical popliteal diseases, the authors have singled out four rare syndromes. The popliteal vein may be trapped due to fibrous strangulation or, more often, to compression by the hypertrophied gastrocnemius muscle. This requires proper diagnosis and surgical management prior to thrombosis onset. Synovial cysts raise no diagnostic problems, unless they mimic an episode of phlebitis; echotomography has now become essential for diagnosis. Desmoid tumors for which predominant extra-abdominal occurrence sites are the popliteal fossa, the leg and thigh, are difficult to excise completely, especially at the popliteal level, and are a major technical challenge because of the inclusion of the vasculonervous pedicle. Lastly, in sports pathology, one must be able to recognize the painful fabella syndrome (osteochondritis of sesamoid fibrocartilage in lateral head of gastrocnemius), so as not to mistakenly implicate vascular disease. New developments in imaging (namely, real time CT-echography) are of major help to clinicists, who should, nonetheless, remain chiefly responsible for detecting these diseases.

Arterial Occlusive Diseases↗

PubMed1989

[A case of remarkable bronchial stenosis due to aspiration of delayed-release iron tablet].

This report describes a rare case of bronchial mucosal injury caused by aspiration of a delayed-iron tablet. A 44-year-old woman had been taking delayed-iron tablets (Feto-Gradumet) regularly because of iron deficiency anemia, and accidentally aspirated a tablet into her bronchus. After this accident, she had complained of wheezing and shortness of breath. On bronchoscopy, the bronchial mucosa of left lower lobe initially showed remarkable swelling and redness, and became corroded and narrowed gradually by iron toxicity over several months, although we tried to remove some fragments of tablet as completely as possible. While we had examined her bronchi repeatedly by bronchoscopy, the bronchial mucosa gradually normalized during 15 months, but moderate stenosis of the left basal bronchus remained. The pathological findings showed infiltration of inflammatory cells, edema and granuloma formation in the submucosal region. This report suggests that the bronchial injury was due to the toxicity of persistent ferrous sulfate eluted from the iron tablet which had adhered firmly to the wet bronchial wall for a long time.

Adult↗

PubMed1978

Two instances of bile reflux without acute pancreatitis.

In two patients in whom most of the bile and the pancreatic juice were mixed, one within the pancreatic duct because of a presumed injury to the ampulla of Vater and the other within the bile duct secondary to a tumor of the ampulla of Vater, there was no pathologic evidence of acute pancreatitis within the pancreas. This was true even though there was chemical evidence that trypsin in its active form passed through the pancreas. On explanation for this is that trypsin inhibitors contained in human bile and pancreatic juice may bind trypsin.

Acute Disease↗

PubMed1980

[Syndrome caused by extrinsic compression of the celiac trunk (apropos of 4 cases)].

On the basis of angiographic documentations the Authors report on 4 observations (3 men and 1 woman) of extrinsic compression of the coeliac trunk symptomatologically evidenced through abdominal pain attacks. All the patients were treated surgically by resection of the median arcuate ligament of the diaphragm. In one case distal pancreatic resection was also performed on account of accompanying chronic pancreatitis. The long-term results were excellent in 3 cases, and good in 1. The diagnosis and surgical indication were made possible after repeated biochemical and instrumental investigations in order to exclude different pathologies (vascular, biliary, pancreatic, gastrointestinal) which might account for the reported symptoms. There is still discussion on the unresolved problem of the pathogenesis of the pain, as well as on surgical tactic and the advisability of completing resection of the arcuate ligament by sympathicectomy or coeliac ganglionectomy.

Abdomen↗

PubMed1995

Noninvasive assessment of renal artery stenosis. A comparison of MR angiography, color Doppler sonography, and intraarterial angiography.

The purpose of this study was to evaluate MR angiography (MRA) and color Doppler sonography as noninvasive screening methods in suspected renovascular hypertension. Fifty-five consecutive patients with arterial hypertension were examined prospectively using high resolution 3-D TOF MRA and color Doppler sonography. Intraarterial angiography was the standard of reference. Stenoses of 60% or more were regarded as significant. MR angiograms were evaluated by 3 independent observers who studied 110 main renal arteries. All 8 significant stenoses and 2 occlusions were correctly classified with MRA while one 60% stenosis was underestimated by color Doppler sonography. Mild stenoses were overestimated by MRA in 4 and by color Doppler sonography in 6 cases. A drawback of both methods was the large number of not evaluable arteries (6 in MRA, 11 in color Doppler sonography). These arteries were regarded as pathologic because stenosis could not be excluded. Due to this fact specificities of MRA and color Doppler sonography were 90% and 85% respectively. Accessory vessels were detected in 47% (8/17) by MRA and in 0% (0/17) by color Doppler sonography.

Adult↗

PubMed1979

[Aortometric correlations in normal and pathological subjects].

The chest roentgenograms of 691 normal, arteriosclerotic and hypertensive patients have been reviewed for measurements of the aortic knob. There is a significant correlation between the width of the aorta and age, but no such correlation was found with the degree of hypertension. The comparison between average widths of the aorta in the 3 categories of subjects has shown its increase in arteriosclerotic and hypertensive patients.

Adult↗

PubMed1989

[Stenosing and perforated ulcers of the small intestine related to potassium chloride in enteric-coated tablets. Apropos of 11 cases].

The enteric coated KCl tablet formulation generates complications that affect selectively the small intestine. A novel 1 g KCl tablet preparation proved to be accountable for the development of a specific type of intestinal disease. 11 cases of stenotic ulcers of the proximal ileum have been treated at the Clinique chirurgicale "C" (CHRU, Nancy) since January 1986, 9 of them presenting with perforations. These 11 patients required potassium replacement, which was being supplied by the same tablet formula. A study of these 11 cases focusing on the patients history and clinical characteristics was carried out, that included both macroscopic and microscopic examinations of the lesions. Arterial and venous networks were visualized by X-ray in two surgical tissue specimens, respectively, following injection of contrast material. The authors were thus able to bring forth evidence of the clinical uniqueness (prodromal pain reminiscent of König's syndrome and peritonitis characterized by asthenia); to identify the main risk factor (i.e., reduced bowel movement); as well as describe the basic lesion (pylorus-like stenosis), and propound a novel theory concerning the etiology and the pathology of this condition. The observation of the aforementioned cases initiated a nation-wide, post-marketing pharmacological survey, which resulted, as did a similar investigation which had been carried out in the States, in the discontinuation of any treatment by this type of galenic form of the product.

Adult↗

PubMed1983

[Light and electron microscopic studies of the epididymis in 30 patients with obstructive azoospermia].

The epididymal tissue and the testis biopsy from 30 patients with obstructive azoospermia, who had undergone refertilization operations, were investigated by light- and electron microscopy. The findings give an insight into the morphologically recognizable tissue relationships, which one finds in patients with congenital or acquired obstruction of the deferent duct. A severe blockage of the testicular secretion is found in the epithelium of these epididymal ducts and demonstrate considerable pathological tissue changes, which indicate an intense resorptive activity. Intra-luminal spermatophages, which are loaded with phagocytized spermatozoa fragments, penetrate through the epithelium. Also great numbers of monocytes, as well as mast cells, and lymphocytes appear in the interstitium. The autoimmune reaction, induced by the continual blockage of epididymal passage over a long period of time, is discussed.

Adult↗

PubMed1983

[Echographic study of the inferior vena cava in abdominal neoplastic pathology. Comparison with the inferior cavography].

The authors evaluated the reliability of echography in the involvement of the inferior vena cava in the abdominal tumors. 137 patients were studied with echography and 125 with inferior cavography too. All the diagnosis were confirmed with arteriography and/or CT and/or surgical findings. The reliability of the echographic method was significant, and particularly in case of emboli and tumor invasion.

Abdominal Neoplasms↗

PubMed1983

[Subclavian-carotid artery transposition in the therapy of lesions of the proximal subclavian artery].

Employing an extrathoracic approach 10 patients were operated upon for 12 obstructive lesions of the subclavian arteries using carotid-subclavian anastomosis. The operation was indicated 3 times for the pathological entity of arterial stenosis embolizing into the vascular periphery, 3 times for claudication of the upper extremity and 4 times for cerebro-vascular insufficiency. Followed up to 31 months all anastomoses remained patent. All the complications were managed conservatively and were considered of minor importance.

Adult↗

PubMed1986

Pathogenetic mechanism of stenosis in the intramural coronary artery.

In order to clarify the pathogenetic mechanism of stenosis in the intramural coronary branch, morphological changes were examined by postmortem coronary angiography and determination of the Coronary Stenosis Index of the Myocardium (CSIM) were made in hearts obtained by autopsy from 10 patients with hypertension, 15 with normotensive myocardial infarction, 25 with hypertensive myocardial infarction, 6 with mitral valvular disease, 7 with aortic stenosis and 14 control subjects. CSIM was significantly higher in patients with hypertension, infarction with hypertension and aortic stenosis than in other three groups, indicating higher incidence of stenosis in those with a left ventricular pressure load. There was no specific correlation between the degree of stenosis of the epicardial coronary artery and that of the intramural coronary branches supplied by the former in any groups examined. Major pathological changes of the intramural coronary branches were muscular hypertrophy of media and proliferation of internal elastic lamella, both observed with a high incidence in vessels with high CSIM values. These findings suggest that intramural pressure which exerted extravascular pressure played an important role in the pathogenetic mechanisms of stenotic changes in the intramural coronary branches.

Adult↗

PubMed1991

Restenosis after percutaneous transluminal coronary angioplasty: pathologic observations in 20 patients.

Histopathologic examination was performed in 20 patients undergoing antemortem coronary angioplasty. Thirty-four lesions were dilated and the interval between coronary angioplasty and death ranged from several hours to 4 years. Intimal proliferation of smooth muscle cells, as a major cause of restenosis, was observed in 83% to 100% of 28 lesions examined 11 days to 2 years after coronary angioplasty. In 20 lesions examined within 6 months, proliferating smooth muscle cells were predominantly of the synthetic type and there was abundant extracellular matrix substance chiefly composed of proteoglycans. In eight lesions examined between 6 months and 2 years, contractile type smooth muscle cells were dominant and extracellular matrix was composed chiefly of collagen. In three lesions examined after 2 years, evidence of antemortem coronary angioplasty was hardly identifiable and these lesions were almost indistinguishable from conventional atherosclerotic plaque. These temporal changes in histologic pattern provide a pathologic background for clinical reports that restenosis is predominantly found within 6 months after coronary angioplasty. Morphometric analysis revealed that the extent of intimal proliferation was significantly greater in lesions with evidence of medial or adventitial tears than in lesions with no or only intimal tears.

Aged↗

PubMed1989

[Duplex sonography of the internal jugular vein].

Based on defined diagnostic criteria high-resolution Duplex sonography allows the accurate evaluation of normal and pathological jugular vein. Compared to examinations with only the B-mode the diagnostic accuracy is higher with the duplex system with additional display of venous flow signals. Normal findings and results of duplex sonography in patients with venous inflow congestion, thrombosis and aneurysm of the jugular vein are presented, and their clinical relevance of the method discussed.

Aneurysm↗

PubMed1975

Postnatal development of obstruction in coarctation of the aorta: role of the ductus arteriosus.

The sequence of events leading to the development of acute obstruction in two infants with coarctation has been defined by clinical, hemodynamic, and angiographic studies. One infant had normally related great arteries and an isolated coarctation, while the other infant had transposition with a hypoplastic right ventricle, a ventricular septal deffect, narrowing of the aortic isthmus, and a localized site of coarctation. In each instance, a posterior aortic shelf--the basic pathologic lesion in coarctation--could be observed angiographically. Signs of aortic obstruction were absent, however, as long as the ductus arteriosus was widely patent. Following ductal obliteration, femoral pulsations diminished, a peak systolic pressure difference was recorded between the ascending and descending aorta, and a discrete area of juxtaductal coarctation was seen. The basic malformation (posterior aortic curtain) would appear to exist in utero, possibly as an aortic branch point. This lesion is nonobstructive as long as blood can traverse the aortic isthmus through the aortic end of the ductus into the descending aorta. Postnatally, as the ductus arteriosus undergoes constriction at its aortic insertion, signs of acute aortic obstruction may b =ecome apparent. Normal femoral arterial pulsations during the newborn examination do not definitively exclude coarctation. Pediatricians should recheck at 2 weeks of age if the infant is asymptomatic or sooner if there are signs of cardiac failure to establish the presence or absence of this defect.

Angiography↗

PubMed1982

Significance of the angiographic morphology of localized coronary stenoses: histopathologic correlations.

Postmortem coronary angiographic morphology was correlated with histologic sections of 73 localized subtotal coronary artery stenoses (50-99% reduction of luminal diameter) to determine whether complicated or uncomplicated atherosclerotic lesions could be detected angiographically. Lesions were divided into two types, according to angiographic morphology: Type I stenoses had smooth borders, an hourglass configurations, and no intraluminal lucencies; type II stenoses had irregular borders or intraluminal lucencies. Histologic sections were also divided into two types: "uncomplicated" stenoses had fatty or fibrous plaques with intact intimal surfaces and no superimposed thrombus; "complicated" stenoses manifested plaque rupture, plaque hemorrhage, superimposed partially occluding thrombus, or recanalized thrombus. Among 35 lesions with type I angiographic morphology, four (11.4%) were complicated lesions histologically. Among the 38 stenoses showing type II angiographic morphology, 30 (78.9%) were complicated lesions. Postmortem angiography thus had a sensitivity of 88% and specificity of 79% for detecting complicated stenoses on the basis of irregular borders or intraluminal lucencies. Pathologic studies have shown that acute occlusive thrombosis of a coronary artery is usually associated with complicated atherosclerotic stenoses. Thus, complicated lesions represent a greater risk factor for acute myocardial infarction or sudden death than do uncomplicated lesions. This study suggests that coronary stenoses characterized angiographically by irregular borders or intraluminal lucencies are probably the clinically more dangerous "complicated" type.

Angiography↗

PubMed1980

[Vascular complications after the treatment of carcinoma of the cervix (author's transl)].

Vascular complications after this treatment are rare. Artery stenosis or occlusions, more often iliac, are well recognized complications of postoperative radiotherapy. These segmental lesions, sometimes, are pathological lesions similar to arteriosclerotic changes. These lesions may be corrected later on after the treatment of carcinoma of the cervix. The venous complications often present later and tall within the context of post thrombotic syndrome. Conservative treatment is indicated alone. A well recognized complication, lymphedema is usually mild; a superimposed iliofemoral thrombophlebitis often may be suspected.

Adult↗

PubMed1980

Cystic thymoma simulating pulmonary stenosis.

A 36-year-old man presented with chest pain, an anterior mediastinal mass and a loud pulmonary systolic murmur. At operation a large, tense, well encapsulated, cystic thymoma was found to be compressing the right ventricular outflow tract and the main pulmonary trunk, producing a systolic thrill over the artery. After excision of the cyst, the thrill and the murmur disappeared and there was complete symptomatic relief. Classification, pathology, clinical presentation, diagnosis and treatment of cysts of the thymus are discussed. The syndrome of pulmonary artery compression characterized by a triad of chest pain, dyspnoea and a loud pulmonary systolic murmur, which decreases in intensity during inspiration, is described. Pertinent literature on cysts of the thymus, and acquired pulmonary stenosis due to extrinsic compression is reviewed.

Adult↗