ABSTRACT
Anatomic variations of the hepatic artery, which occur in 30 to 50% of patients, are a very important factor to be considered for Whipple procedure. The most common variations are those coming from the superior mesenteric artery, left gastric artery and the aorta. We report a 58-year-old woman with a story of one month of epigastric pain, jaundice and progressive itching. Magnetic resonance imaging showed a mass in the head of the pancreas. During pancreatoduodenectomy a left hepatic artery (LHA) emerging from the gastroduodenal artery and an accessory LHA emerging from the left gastric artery, were observed. The rest of the surgery was performed with no incidents. The patient had an uneventful postoperative evolution.
Subject(s)
Female , Humans , Middle Aged , Hepatic Artery/abnormalities , Pancreaticoduodenectomy/methods , Anatomic Variation , Hepatic Artery/surgery , Medical IllustrationABSTRACT
La aortitis sifilítica es frecuentemente asociada a aneurismas y/o enfermedad coronaria estenótica ostial, sin embargo este tipo de lesiones son raramente reportadas. Se reporta un caso deaneurisma de tronco arterial braquiocefálico con compresión y desplazamiento de estructuras vecinas,erosión esternal y su tratamiento...
A aortitis sifilítica é frequentemente associada a aneurisma e/ou enfermedade estenotica ostial, sem no entanto este tipo de lesão são raramente reportadas. Apresentamos um caso de aneurisma do tronco arterial braquiocefálico com compressão e deslocamento de estrcturas vizinhas, erosão esternal e seu tratamento...
Syphilitic aortitis is often associated with aneurysms and ostial stenotic coronary however such injuries are rarely reported. We report a case of brachiocephalic arterial trunk aneurysm with compression and displacement of neighboring structures, sternal erosion and its treatment...
Subject(s)
Humans , Male , Middle Aged , Aortic Aneurysm/surgery , Truncus Arteriosus , Syphilis, Cardiovascular/complications , Syphilis, Cardiovascular , Brachiocephalic TrunkSubject(s)
Antitubercular Agents/pharmacology , DNA Mutational Analysis , DNA, Bacterial/genetics , Drug Resistance, Multiple/genetics , Isoniazid/pharmacology , Microbial Sensitivity Tests , Mycobacterium tuberculosis/drug effects , Polymerase Chain Reaction , Polymorphism, Single-Stranded ConformationalABSTRACT
OBJECTIVE: The study was conducted to evaluate usefulness of single strand conformation polymorphism (SSCP) over DNA sequencing in the diagnosis of rifampicin (Rif)-resistant tuberculosis. METHODS: Forty seven isolates of Mycobacterium tuberculosis (MTB) Rif-resistant and 25 Rif-sensitive were obtained from Vancouver, Mexico city and New Delhi and were analyzed by polymerase chain reaction (PCR) amplification of rpoB gene and the mutations were identified by DNA sequencing and SSCP. RESULTS: The mutations observed by DNA sequencing in 47 RIF-resistant isolates showed that the most common mutation among Vancouver isolates was in codon 526, Hist-->Arg and in Mexico isolates was in codon 531, Ser-Leu and New Delhi isolates was in codon 516, Asp-->Val. Using fluorescence based PCR-SSCP, it was possible to distinguish Rif-resistant isolates from Rif-sensitive isolates. CONCLUSION: DNA sequencing is a highly accurate method for the detection of mutations associated with drug resistance in tuberculosis but is more expensive and requires special equipment and personnel. SSCP is a simple, accurate method and suitable for analysis of large number of samples and the results are available in less than 72 hours.