1/1215. Wasting of the small hand muscles in upper and mid-cervical cord lesions.Four patients are described with destructive rheumatoid arthritis of the cervical spine and neurogenic wasting of forearm and hand muscles. The pathological connection is not immediately obvious, but a relationship between these two observations is described here with clinical, radiological, electrophysiological and necropsy findings. Compression of the anterior spinal artery at upper and mid-cervical levels is demonstrated to be the likely cause of changes lower in the spinal cord. These are shown to be due to the resulting ischaemia of the anterior part of the lower cervical spinal cord, with degeneration of the neurones innervating the forearm and hand muscles. These findings favour external compression of the anterior spinal artery leading to ischaemia in a watershed area as the likeliest explanation for this otherwise inappropriate and bizarre phenomenon.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/1215. Endobronchial stenting for extrinsic compression caused by pulsatile pulmonary artery in a 4-week-old infant.Respiratory compromise secondary to external vascular compression may complicate the course of infants and neonates undergoing repair of congeni tal heart disease. Management of such complications usually involves prolonged ventilatory support and even additional high-risk surgical procedures. In recent years, endobronchial placement of self-expanding stents became a realistic treatment option, although there is controversy as to which of the many stents available today give the best results. We report the first successful endobronchial placement of a self-expanding stent in a 4-week-old infant. This conservative treatment for extrinsic airway compression led to the rapid extubation and recovery of the patient.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
3/1215. Stenting of a stenotic radial artery coronary graft: a new therapeutic scenario in coronary artery disease.With the increasing application of arterial coronary revascularization, a number of patients may develop arterial graft obstructive disease. In addition, the predominantly muscular structure of the radial artery wall may predispose radial artery coronary grafts to spasm. For the first time, we describe a case of stenting of a stenotic free radial artery graft and discuss the technical and pathophysiological aspects of the procedure.- - - - - - - - - - ranking = 5.5keywords = artery (Clic here for more details about this article) |
4/1215. Pathogenic role of glomerulo-tubular junction stenosis in glomerulocystic disease.Glomerulocystic disease is an uncommon cystic renal condition characterized by cystic dilatation forming a glomerular cyst. The pathogenesis of this familial disease is unknown. We performed a serial section study using a biopsy specimen of a 16-year old female patient with glomerular cystic disease who had a family history of end stage renal failure. A total of 14 different glomeruli were analyzed, four of which exhibited a cystic appearance. Five glomerulotubular junctions were observed by serial sections, two of which had a stenotic appearance where glomerular cystic changes and periglomerular fibrosis were observed concomitantly. There were no such cystic glomerular changes in the other three glomeruli with non-stenotic glomerulo-tubular junctions. These findings suggest that the glomerular cystic lesion develops as a consequence of glomerulo-tubular junctional stenosis probably caused by periglomerular fibrosis.- - - - - - - - - - ranking = 19.171576824531keywords = stenosis (Clic here for more details about this article) |
5/1215. coronary angiography with 5 French diagnostic catheters may miss an ostial left main stenosis.Critical ostial left main disease may lead rapidly to sudden death and is, therefore, of paramount importance to diagnose. While the number of cardiac catheterizations is increasing, government and third party reimbursement sources are imposing pressure to perform more studies in an outpatient setting, as the economic resources for medical procedures are shrinking. Outpatient cardiac catheterization requires the patient to ambulate within several hours after the procedure. In order to allow patients to safely ambulate early after their procedures, 5 French catheters are often used (whether the femoral or brachial approach is used) rather than the standard 7 French catheters. We describe a patient with an ostial left main stenosis that was not visualized when coronary arteriography was performed using a diagnostic 5 French catheter. Selective intubation of the left main coronary artery was easily achieved without damping of the pressure tracing. Selective coronary angiography did not demonstrate the ostial stenosis, and there appeared to be a normal amount of contrast refluxing into the aortic root. When the patient returned for an angioplasty and a guiding angiogram was performed with an 8 French catheter, an ostial stenosis was evident with coronary angiography.- - - - - - - - - - ranking = 27.340207554343keywords = stenosis, artery (Clic here for more details about this article) |
6/1215. Superior mesenteric artery (Wilkie's) syndrome: report of three cases and review of the literature.Of the three cases of superior mesenteric artery (Wilkie's) syndrome presented, one was associated with anorexia nervosa; this association has not been reported before. Two patients were treated surgically with a duodenojejunostomy, and one was treated medically. Vascular compression of the duodenum is a controversial subject. The syndrome probably is more common than generally recognized and is underdiagnosed due to its exclusion from the differential diagnosis of small-bowel obstruction. Its recognition is important because early diagnosis of a partial obstruction may allow for medical rather than surgical intervention, as exemplified by our third case.- - - - - - - - - - ranking = 2.5keywords = artery (Clic here for more details about this article) |
7/1215. Left main coronary artery compression by aneurysmal pulmonary artery in a patient with tetralogy of fallot with absent pulmonary valve.We describe an 11-year-old girl with tetralogy of fallot and absent pulmonary valve, who on selective coronary angiography was found to have extrinsic compression of the left main coronary artery by the aneurysmally dilated pulmonary artery. This abnormality has not been reported previously.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
8/1215. Stenosis of the nasal vestibule and its treatment.From our own experience and a review of the literature, we present a few techniques which, in our eyes, give the surgeon the possibility to treat most encountered cases of stenosis of the nasal vestibule. During 1991 to 1998 the author in Stuttgart (W.G.) performed simple z-plasty combined with local flaps in 6 patients and composite grafts only in 12 cases, to correct nasal vestibule stenosis. The author in Lausanne (R.M.), who first described the paranasal myocutaneous flap to correct not only nasal vestibule stenosis but also alar base malposition has treated over 50 patients with this technique and with composite grafts during the last 20 years.- - - - - - - - - - ranking = 11.502946094718keywords = stenosis (Clic here for more details about this article) |
9/1215. Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization.OBJECTIVE: To report a case of cervical stenosis repaired by hysteroscopic cervical shaving that created a smooth passage for ET in a patient undergoing IVF. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a history of multiple failed IVF attempts in whom ET was extremely difficult. INTERVENTION(S): Operative hysteroscopy with creation of a cervical tract. MAIN OUTCOME MEASURE(S): Ease of postoperative ET and outcome of IVF treatment after the hysteroscopic procedure. RESULT(S): Easy performance of ET and a resulting triplet pregnancy. CONCLUSION(S): This novel hysteroscopic repair of cervical stenosis resulted in a markedly easier ET and a viable pregnancy.- - - - - - - - - - ranking = 23.005892189437keywords = stenosis (Clic here for more details about this article) |
10/1215. Posterior decompression of the vertebral artery narrowed by cervical osteophyte: case report.BACKGROUND: Symptomatic vertebral artery compression caused by cervical spondylosis usually is caused by compression of the artery by osteophytes arising from the uncinate process. Compression from facet joint osteophytes is seldom reported. CASE DESCRIPTION: A 69-year-old male developed symptomatic vertebral artery stenosis secondary to an osteophyte arising from the superior facet of the sixth cervical vertebra posterior to the artery. A posterior decompression of the vertebral artery with removal of the offending facet joint complex relieved the patient's transient neurologic events. CONCLUSION: Symptomatic vertebral artery stenosis may be caused by osteophytes compressing the vertebral artery anteriorly from the uncinate process or posteriorly from the facet complex.- - - - - - - - - - ranking = 13.168630729812keywords = stenosis, artery (Clic here for more details about this article) |
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