RESUMO
The patient was a 37 year-old man. We diagnosed Loeys-Dietz syndrome based on his physical characteristics that were widely spaced eyes and brachycephaly etc. Since he developed De Bakey III b aortic dissection 3 months later, he needed surgical repair for saccular-shaped distal arch aortic aneurysm. We performed total aortic arch replacement for the aneurysm and valve-sparing aortic root reconstruction for dilatation of the Valsalva sinus. Furthermore we performed the frozen elephant trunk technique for residual aortic dissection at the same time. After 18 months from the operation, we were able to recognize by computed tomography that the false lumen of the aorta next to the stent graft was thrombosed and absorbed and finally disappeared. The stent graft treatment for patients with connective tissue disease might be an effective method and deserves more attention.
RESUMO
A 22-year-old man shot himself with a nail gun. He was admitted to a local hospital with chest pain. Chest x-ray film and chest computed tomography showed 5 nails penetrating the left thorax and some of these nails were considered to reach the pericardium. He was transferred to our hospital for intervention. Left thoracotomy was performed. Three nails reached the left ventricle and one nail was embedded the left lung. The last nail was found by transesophageal echocardiography to be completely buried in the left ventricle wall. All nails were removed and the left ventricular wounds were repaired with felt 4-0 surgipro mattress sutures. He made an uneventful postoperative recovery with a normal postoperative echocardiography and he was discharged on postoperative day 12 in good condition.
RESUMO
To assess the influence of smoking on glycated albumin [GA] to hemoglobin A1c [HbA1c] ratio among type 1 diabetes mellitus [T1DM] patients. Eighty-one T1DM patients [49 females, 32 males, mean age 48 +/- 18 years] were recruited, and data concerning GA/HbA1c ratio and smoking were collected. The median levels of GA and HbA1c were 23.3 and 7.4%, respectively. Independent of age, sex and/or body mass index, the GA/HbA1c ratio in smokers was significantly lower than that in nonsmokers [3.0 vs. 3.3, p < 0.05]. The data suggest that smoking might affect the GA/HbA1c ratio among T1DM patients
Assuntos
Humanos , Masculino , Feminino , Hemoglobinas Glicadas/metabolismo , Diabetes Mellitus Tipo 1/metabolismo , Índice de Massa Corporal , Albumina SéricaRESUMO
A 74-year-old man with chronic renal failure complained of back pain. Computed tomography revealed an infected thoracic pseudoaneurysm at the descending thoracic aorta. An endovascular stent graft was repaired with exclusion of a false aneurysm. After surgery, he complained of post-prandial cough, minor hemoptysis and deglutition with difficulty. Esophagoscopy and bronchoscopy showed a fistula between the left main bronchus and the esophageal diverticulum. Fistulectomy was planned after his general condition became stabilized, but the patient died of rebleeding on day 64 after stent grafting. The histological examination revealed a congenital bronchoesophageal fistula.