ABSTRACT
The placement of Swan Ganz (SW) catheters and inferior vena cava (IVC) filters are common procedures performed in critically ill patients. Many reports describe the independent misplacement of SG catheters and IVC filters, and others have reported migration of IVC filters and entanglement of various intravascular devices in IVC filter. Our patient is a 70-year-old Caucasian woman who underwent an aortic valve replacement and coronary artery bypass grafting. The patient developed a deep venous thrombosis and an infrarenal IVC filter was placed without incident. A Swan Ganz catheter was placed later in the postoperative period and became entangled in the IVC filter. We advised operative removal after several unsuccessful percutaneous attempts to retrieve the catheter. IVC filters are indicated for prevention of fatal pulmonary emboli in patients with a contraindication to anticoagulants or with recurrent embolism despite adequate anticoagulant therapy. Complications of IVC filters include caval thrombosis, retroperitoneal hemorrhage and perforation of the IVC, hepatic veins, duodenum and aorta. We describe our evaluation and operative approach and make recommendations for prevention of entangling the SG into the IVC filter.
Subject(s)
Catheterization, Swan-Ganz/instrumentation , Coronary Artery Bypass , Equipment Failure Analysis , Heart Valve Prosthesis Implantation , Postoperative Complications/surgery , Vena Cava Filters , Aged , Aortic Valve , Device Removal , Female , Humans , Postoperative Complications/diagnosis , Pulmonary Embolism/diagnosis , Pulmonary Embolism/surgery , ReoperationABSTRACT
We describe a case of a 65-year-old Caucasian woman found to have an enlarging mass of the left adrenal gland. Laboratory examination revealed the mass to be nonfunctional. The patient underwent an uneventful left adrenalectomy. Pathological examination revealed the mass to be a leiomyoma. These tumors are benign and develop from smooth muscle cells. They can occur in any part of the body where smooth muscular layers exist, but occur frequently in the uterus and gastrointestinal tract. This case report presents a review of the recent literature on this rare entity.
Subject(s)
Adrenal Gland Neoplasms/diagnosis , Leiomyoma/diagnosis , Aged , Diagnosis, Differential , Female , HumansABSTRACT
The multitude of actions and interacting components involved in inciting and sustaining myointimal hyperplasia and restenosis effectively precludes the use of a single type of intervention. No pharmacologic approach has been conclusively shown to prevent coronary restenosis after balloon angioplasty or graft restenosis after peripheral arterial bypass. Although no human studies have been performed to prevent restenosis with gene therapy, the animal data are compelling, and the local delivery of various inhibitory agents may represent a novel way of preventing restenosis in vascular beds subjected to endovascular or traditional open procedures. Until these modalities are proved effective, the treatment of vascular stenosis due to internal hyperplasia remains within the domain of the surgeon.
Subject(s)
Angioplasty, Balloon, Coronary , Angioplasty, Balloon , Arterial Occlusive Diseases/physiopathology , Coronary Artery Disease/physiopathology , Fibromuscular Dysplasia/physiopathology , Growth Substances/physiology , Animals , Arterial Occlusive Diseases/therapy , Cell Division/physiology , Combined Modality Therapy , Coronary Artery Disease/therapy , Endothelium, Vascular/physiopathology , Fibromuscular Dysplasia/therapy , Humans , Muscle, Smooth, Vascular/physiopathology , Prognosis , RecurrenceABSTRACT
Extracranial cerebrovascular disease (ECVD) is a major contributor to cerebrovascular accidents in the modern era. Cerebrovascular accidents (CVAs) are the third leading cause of death in the United States with 500,000 new or recurrent CVAs each year. Approximately 15,000 people die annually as a direct result of a stroke resulting in a cost of approximately $18 billion when hospital charges and loss of productivity figures are tabulated. The social and economic impact of this disease mandates a unified approach to its management.
Subject(s)
Immunoblastic Lymphadenopathy/diagnosis , Biopsy , Female , Humans , Middle Aged , Skin/pathologySubject(s)
Oligospermia/surgery , Adult , Biopsy , Diagnosis, Differential , Epididymis/surgery , Follow-Up Studies , Humans , Male , Methods , Oligospermia/diagnosis , Oligospermia/etiology , Testis/pathology , Vas Deferens/surgeryABSTRACT
PIP: Male sterility may be caused by a numerical or structual abnormality of the chromosomes; these disorders can disturb the development and maturation of the male sex cells, excluding therapeutical treatment. 6% of the infertile men have chromosome aberrations. The authors have studied sterility in men with normally developed testicles and secondary sexual characteristics. In the 1st group of patients, there was no evidence of chromosome aberration; histological examinations of the testicles showed all stages of the spermato- and spermiogenesis. In this group, infertility was caused by secretory obturation. In the 2nd group, there was no chromosome aberration but the spermatogenesis was completely stopped. The influence of cytogenic factors is excluded as the choromosomes were normal. In the 3rd group, there were several chromosome abnormalities. However these abnormalities were not having any effect on the spermatogenesis. It is possible that they were congenital. The 4th group consisted of patients with no chromosome abnormality, but their spermatogenesis was interrupted after the division and the spermatocytes did not develop properly. The authors feel that histology is the best method available to understand the etiology of male infertility.^ieng