[Correction of pathological foreskin constriction through phimosisbells].
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Adolescent↗
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Results for “Constriction, Pathologic”
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Hypothesis--Head pain: congenital, anatomical, pathological and neurosurgical correlates.
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Adult↗
Pathogenesis of acute pancreatitis: pancreatic ductal-interstitial-vascular and lymphatic pathways.
The generally accepted theory explaining the pathogenesis of pancreatic autodigestion (acute pancreatitis) is analysed. The pathways are discussed through which the content of the pancreatic duct system, the digestive enzymes, may escape to enter the acinar cells and the pancreatic interstices, together with the effect of the enzymes on the pancreatic vessels and thus on pancreatic blood flow. The potential consequences of vascular damage are described as well as the importance of pancreatic lymphatics in the transport of the escaped enzymes from the interstices. Although no definite answer can be given to the basic problem whether acute autodigestion of the pancreas is a result of some intra- or extra-acinar process, it is suggested that the intra- and extra-acinar processes are linked and are decisive in launching the pathological process.
Acute Disease↗
Effusive-constrictive hemodynamic pattern due to neoplastic involvement of the pericardium.
Eight patients with metastatic malignancy of the pericardium who demonstrated the hemodynamics of subacute effusive-constrictive pericarditis were studied. All patients had clinical evidence of cardiac tamponade due to malignant pericardial effusion and were referred for therapeutic pericardiocentesis. In six in whom pericardiocentesis was successfully performed, right atrial pressure remained elevated after pericardiocentesis and return of the intrapericardial pressure to zero; in these patients, hemodynamic data were initially compatible with tamponade but suggested constriction after removal of the pericardial fluid. In the remaining two patients, echocardiography revealed pericardial fluid, but attempted pericardiocentesis was unsuccessful. In these two patients, the hemodynamic data suggested pericardial constriction; subsequent pathologic examination revealed neoplastic involvement of the visceral pericardium. Thus, subacute effusive-constrictive pericarditis, previously recognized as a complication of tuberculosis or mediastinal radiation, may also be due to metastatic malignancy. The syndrome can readily be demonstrated when right heart catheterization is performed in conjunction with pericardiocentesis.
Cardiac Tamponade↗
[The Doppler test: its practical importance in the study of lesions of the supra-aortic trunks].
Ultrasonography by the Doppler effect is of indisputable use in the investigation of lesions of the supra-aortic trunks leading to the brain. It allows a direct study of the extracranial carotidian and vertebral axes, and gives an idea of the intracerebral circulation. It detects the main lesions affecting them, provided that such lesions have hemodynamic repercussions. The Doppler does not replace arteriography, but is a complementary exam making it possible to decide on or to dismiss the need for it. Its harmlessness and simplicity make it a standard exam in cerebral vascular pathology.
Arterial Occlusive Diseases↗
Schistosoma mansoni and S. haematobium infections in Egypt. III. Extrahepatic pathology.
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Colonic Neoplasms↗
[Chronic pancreatitis and its treatment in diseases of terminal segment of the common bile duct].
Clinical observations embrace 77 cases of chronic pancreatitis combined with various pathologic changes of the choledochal terminal portion. The surgical correction of these changes was carried out upon 73 cases. The follow-up lasting from 2 to 6 years has shown the manifestation of chronic pancreatitis either disappear or subside dramatically in the most cases following the surgical correction of the pathologic changes in the choledochal terminal portion.
Biliary Tract Diseases↗
Paraesophageal hiatus hernia in the aged.
A review of the records of Granada Hills Hospital revealed 4 documented cases of paraesophageal hiatus hernia. One of these geriatric patients presented with incarceration of the gastric fundus, and required an emergency thoracotomy for relief. Paraesophageal hiatus hernia, unlike sliding hiatal hernia, often gives rise to acute surgical problems secondary to incarceration, obstruction, gangrene, perforation or hemorrhage. The approach to the repair operation, may be either abdominal or thoracic, dependent upon the need to correct other associated gastrointestinal pathologic lesions. Unless severe debilitating medical diseases are present, operative intervention is recommended.
Age Factors↗
Epidemiological studies of cerebro-and cardiovascular diseases in the northeast of Japan Part I. Pathological approach to the study in Akita Prefecture.
To define the etiologic factors of Japanese cerebrovascular diseases, a pathological research was conducted on autopsy cases of stroke in Akita Prefecture. In most cases of cerebral hemorrhages, especially in the middle age group (30-59 of age), arteriosclerotic deviations in basal berebral arteries of the circle of Willis and intracerebral small arteries are not found. The authors conclude that cerebral hemorrhage may occur without relationship to disturbances of lipid metabolism, biochemically, and to atherosclerosis, pathologically. Concerning cerebral infarction, especially in the old generation (over 60 years of age), severe arteriosclerotic deviations were recognized both in basal cerebral and intracerebral arteries. These changes were highly influenced by the grade and duration of hypertension, and rarely influenced by hypercholesterolemia. According to the above-mentioned facts, the results obtained from out epidemiological survey were confirmed by the pathological studies.
Adult↗
Isolated stenosis of the pulmonary artery branches--an autopsy case with review of the literatures.
A necropsy of a 21-year-old male with isolated stenosis of the pulmonary artery was presented. The pulmonary artery branches showed various fibrous thickening including atheromata and mural thrombi. Those findings appeared mostly in elastic and large muscular pulmonary arteries as well as in medium sized arteries, while the small arteries and arterioles remained in slight changes. Systemic large elastic arteries seemed to be small and showed atheromatous lesions similar to those of the main pulmonary arteries. Moreover, eight autopsy cases with pulmonary artery stenosis from the literature were shortly reviewed and some pathological findings as an aid for angiographic cardiovascular studies were discussed.
Adolescent↗
Lumbar stenosis. An electromyographic evaluation.
Analysis of bilateral EMG and operative findings reveal that there is a definite correlation between bilateral positive EMG in particular and multiradicular EMG's and the findings of stenosis or spondylosis of the lumbar canal. Electromyography is helpful in identifying the atypical patient or the patient with unilateral symptoms who actually has bilateral pathology. The importance of a bilateral electromyographic examination is emphasized and the rarity of bilateral or multiradicular findings in simple herniated nucleus pulposus.
Constriction, Pathologic↗
[Use of the water-soluble x-ray contrast substance Dimer-X in lumbosacral myelography].
The use of the water-soluble radiocontrast substance Dimer-X in lumbosacral myelography in 22 patients with a stable pain syndrome in the lumbosacral region showed that this method makes it possible to disclose the cause of the disease exactly and to reveal or rule out any neurosurgical pathology of this region. This examination is tolerated well by the patients, does not produce serious complications, and may be conducted in any neurosurgical institution.
Constriction, Pathologic↗
Spontaneous resolution of colonic strictures caused by necrotizing enterocolitis: therapeutic implications.
Colonic strictures are now a well recognized complication in infants surviving necrotizing enterocolitis. We describe the clinical course of seven infants with colonic strictures after necrotizing enterocolitis. Only two demonstrated the finding of fixed fibrotic stricture described in the literature, while the remaining five showed atypical radiographic and pathologic features. Two of the five showed partial or spontaneous resolution of post-necrotizing enterocolitis colonic stenoses on follow-up barium enema studies. In three of four patients with colonic resections, the histopathologic examination revealed a surprising absence of irreversible fibrosis or cicatrix formation. Current surgical practice dictates elective resection of these narrowed colonic segments. The radiologic and pathologic findings in our series of patients suggest surgical resection may be unnecessary in selected cases.
Colon↗
Endomyocardial fibrosis with calcification of the myocardium.
A case of endomyocardial fibrosis with intramyocardial calcification was characterized by symptoms of restrictive cardiomyopathy resembling constrictive pericarditis. Pathological findings were typical of those found in classical Davies' disease, originally encountered and described in Uganda.
Calcinosis↗
[Hydrodynamic and radiologic examination of the common bile duct].
The operative study of the common bile duct was carried out with the hydrodynamics methods (flow and resting pressure) in 433 patients and with the operative cholangiography in 383 patients. The hydrodynamics explorations pointed-out a margin of mistake due to falses positives and negatives of the 2.7% and the operative cholangiographies of the 8.6%. The association of both methods, hydrodynamics and radiologycs, allowed us to estimate that the diagnostic mistake is reduced to 0%. It is established in this work the necessity of carring out the flow, the measure of the resting pressure and the cholangiographies; in all the patients that are operated on the biliary tract because the diagnostic accuracy is the 100%. It is discussed the value of the diameter of the common bile duct for affirming the eventual existence of obstruction of the lower part of the common bile duct and the values are correlated, measured in mm., with pathological founds. It is considered the value of the hydrodynamics methods in the diagnostic of the stenosis of the sphincter of Oddi.
Adolescent↗
[Acquired telangiectases of the lower extremities].
The aim of our study is to place the different forms of telangiectasia of the lower limbs in their clinical categories, before tackling, along with Dr OUVRY, the therapeutic problem with which the phlebologist is daily confronted. The idiopathic telangiectasias of the lower limbs are very common in women, and are considered as simple, but clearly form an entity within the framework of venous pathology : unfortunately we do not have a very precise pathophysiological explanation to provide a basis for prophylaxis, which is still doubtful, or for definitive treatments : nevertheless that is a field for the exercise of the phlebologist's skill. Other types of telangiectasia, which we have mentioned, should call for a search for a general pathology in terms of a complete physical examination from a dermatological viewpoint. More rarely, their precise dermatological category will be that of a dysembryoplasia, while others will be vascular naeval disorders with delayed manifestation. These will all require a specific therapeutic approach.
Capillaries↗
[Endoscopic sphincterotomy. 362 cases (author's transl)].
In addition to its diagnostic value, endoscopic catheterisation of the papilla may be used for the therapeutic purpose of diathermy incision of the papilla and of the intraduodenal portion of the common bile duct. Endoscopic sphincterotomy of this type has been essentially used in choletithiasis and in particular for residual lithiasis. These indications may be widened to include benign stenosis of the sphincter of Oddi, tumours of the ampulla of Vater or even acute pancreatitis. In a total of 362 cases, sphincterotomy was successful in 347 patients, it being possible to remove the calculi present in 279 of the 309 patients treated with success for lithiasis of the common bile duct. Complications occur in approximately 10% of cases, being fatal in 1.4% of cases. These are essentially related to bleeding. Retrospective comparison of mortality after surgical operation and after endoscopic sphincterotomy is in favour of the latter, provided the technique employed is perfect and the indication clearly defined. Performed without general anaesthesia, endoscopic sphincterotomy is above all indicated in the elderly and/or those with other major pathology who can be successfully treated with reduced risk in 93% of cases, as shown by the 140 personal cases of the authors cured between 6 and 36 months ago.
Acute Disease↗
Spinal computed tomography: limitations and applications.
A comprehensive review of 188 spinal computed tomography (CT) scans done over a 9-month period was performed to establish both the shortcomings and applications of the technique. The value of intrathecal enhancement was reviewed in an attempt to establish indications for its use. The data base comprised 51 abnormal scans including cases of spinal trauma, dysraphism, intra- and extraspinal neoplasm, and spinal stenosis. Results indicate that: (1) the introduction of intrathecal contrast media greatly extends the morphologic capabilities of spinal CT in practically all cases where altered anatomy of the spinal canal and its contents is suspected; (2) conventional screening procedures such as plain films of the spine and myelography should be obtained prior to spinal CT in most cases because of their value in defining the location and longitudinal extent of the pathologic process; (3) spinal CT examinations tailored to specific areas of interest result in better characterization of traumatic, dysraphic, and stenotic conditions conceivably leading to better surgical management and more accurate prognosis. At present, spinal CT has its greatest diagnostic usefulness in the evaluation of trauma and its sequela.
Constriction, Pathologic↗