1/1152. Systemic infection with Alaria americana (trematoda).Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/1152. Increased angiotensin-converting enzyme activity in a patient with severe ovarian hyperstimulation syndrome.OBJECTIVE: To assess plasma angiotensin-converting enzyme (ACE) activity in a patient with severe ovarian hyperstimulation syndrome (OHSS). DESIGN: Case report. SETTING: Private, university-affiliated infertility practice. PATIENT(S): A 35-year-old woman with OHSS. INTERVENTION(S): clomiphene citrate induction of ovulation. MAIN OUTCOME MEASURE(S): plasma ACE activity. RESULT(S): The patient had a brain stem infarction as a result of thrombosis caused by severe OHSS. plasma ACE activity was significantly elevated and persisted long after resolution of the OHSS. CONCLUSION(S): Elevated ACE activity appears to have been associated with the development of OHSS in this patient. Further study of the ovarian renin-angiotensin system in the development of OHSS is warranted.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
3/1152. A giant dissecting aneurysm mimicking serpentine aneurysm angiographically. Case report and review of the literature.Intracranial dissecting and giant serpentine aneurysms are rare vascular anomalies. Their precise cause has not yet been completely clarified, and the radiological appearance of such lesions can be different in each case according to the effect of hemodynamic stress on a pathologic vessel wall. For berry aneurysms, available evidence overwhelmingly favors their causation by hemodynamically induced degenerative vascular disease and there is an obvious need to determine the hemodynamic parameters most likely to induce the precursor atrophic lesions. In this study, a case of a giant dissecting aneurysm angiographically mimicking serpentine aneurysm of the right ophthalmic artery is reported and the relevant literature is reviewed to investigate the pathological characteristics and pathogenesis of this lesion. In the present case, radiological investigation of the lesion suggested a serpentine aneurysm, but the diagnosis was corrected to dissecting aneurysm subsequent to the pathological examination of the resected aneurysm. A giant dissecting aneurysm angiographically mimicking serpentine aneurysm and developing as the result of a circumferential dissection located between the internal elastic lamina and media is of particular interest when the etiology of these aneurysms is considered. To our knowledge this is the first report on intracranial dissecting aneurysm mimicking serpentine aneurysm angiographically. Our case illustrates the importance of careful serial section studies for a better understanding of the vascular pathology underlying the processes involved in intracranial serpentine aneurysms. We conclude that serpentine, dissecting and berry aneurysms may all arise by way of similar pathophysiological mechanisms.- - - - - - - - - - ranking = 1608370.7389781keywords = aneurysm, artery, giant (Clic here for more details about this article) |
4/1152. Familial thrombophilia and the prothrombin 20210A mutation: association with increased thrombin generation and unusual thrombosis.The 20210A prothrombin mutation has recently been associated with an increased risk of venous thrombosis, but the mechanism of the increased thrombotic risk in affected persons has not been elucidated. We report on a thrombophilic family in which the proband presented with cerebral vein thrombosis and homozygosity for the 20210A prothrombin mutation as her only identifiable risk factor for venous thrombosis. Extended genotyping of family members revealed seven other affected, but asymptomatic, first-degree relatives (one A/A homozygote and six G/A heterozygotes). plasma levels of prothrombin, prothrombin fragments 1 2 and thrombin-antithrombin complexes were highest in A/A homozygotes, intermediate in G/A heterozygotes and lowest in those with the G/G homozygous normal genotype, while D-dimer levels were elevated only in A/A homozygotes. Our results suggest that the 20210A prothrombin mutation is associated with activation of coagulation and increased thrombin generation, not only in patients with a past history of thrombosis but also in otherwise healthy asymptomatic persons. In a similar fashion to the homozygous factor v Leiden mutation, patients with the homozygous 20210A prothrombin mutation could be at highest risk of thrombosis, as suggested by our patient who presented with unusual thrombosis.- - - - - - - - - - ranking = 215.6877539071keywords = cerebral (Clic here for more details about this article) |
5/1152. Atrial tamponade causing acute ischemic hepatic injury after cardiac surgery.A patient developed late cardiac tamponade after aortic valve replacement and coronary artery bypass grafting. nausea and dramatic elevations of serum aminotransferases were the initial clinical manifestations of cardiac tamponade. Severe acute ischemic hepatic injury secondary to isolated compression of both atrial cavities by two loculated thrombi was diagnosed.- - - - - - - - - - ranking = 1147.9342705909keywords = artery (Clic here for more details about this article) |
6/1152. Subacute stent thrombosis occurring more than one month after implantation for acute myocardial infarction. Description of two cases successfully treated with angioplasty and further stenting.Two patients are described with anterior acute myocardial infarction who had a successful recanalization of a totally occluded left anterior descending coronary artery by means of primary angioplasty and stenting. Reinfarction occurred more than 1 month after implantation. At angiography, a totally occluded left anterior descending coronary artery at the site of stenting was observed and was effectively reopened with angioplasty and stenting in both cases. This report aims to emphasize that acute myocardial infarction still represents a major risk factor for subacute stent thrombosis and that this potentially catastrophic event may occur late after implantation. Potential implications for revascularization strategies and medical treatment are discussed.- - - - - - - - - - ranking = 2295.8685411817keywords = artery (Clic here for more details about this article) |
7/1152. Anemic infarction of the liver resulting from hepatic and portal vein thrombosis.True anemic infarction of the liver is a rare lesion. Most of the reported cases are due to occlusion of the hepatic artery. Whether venous occlusion can result in such anemic infarcts has been disputed although few authentic cases have been reported. A case of polycytheia vera complicated by hepatic and portal vein thrombosis with anemic infarction of a large segment of the liver is presented. The case illustrates that anemic infarcts of the liver can result from venous occlusion. The intense congestion secondary to hepatic vein occlusion may cause secondary arterial hypoperfusion unless the portal vein is available as an outflow tract.- - - - - - - - - - ranking = 1147.9342705909keywords = artery (Clic here for more details about this article) |
8/1152. diagnosis of MCA-occlusion and monitoring of systemic thrombolytic therapy with contrast enhanced transcranial duplex-sonography.A case of a successful systemic thrombolysis of an acute middle carotid artery occlusion is reported. The case underlines the role of contrast-enhanced transcranial color-coded duplex sonography as a noninvasive technique for rapid diagnosis of vessel occlusion in acute stroke. The diagnostic potential of transcranial color-coded duplex sonography for indication and monitoring of intravenous systemic thrombolytic therapy is demonstrated.- - - - - - - - - - ranking = 1147.9342705909keywords = artery (Clic here for more details about this article) |
9/1152. Spontaneous native aortic valve thrombosis.Spontaneous thrombosis of a native aortic valve is an uncommon event that usually follows local trauma, such as cardiac surgery or left heart catheterization, or occurs as a complication of bacterial endocarditis. We report the case of a 65-year-old woman with a history of retinal artery occlusion and severe aortic valve stenosis, in whom transesophageal echocardiography revealed a mobile mass attached to the ventricular surface of the aortic valve. There was no evidence of any hypercoagulable state or infection process. Surgery was performed and a severely stenotic valve resected; a partially organized and firmly adherent free-floating thrombotic mass was observed on the ventricular surface of the aortic valve. Histologic examination demonstrated an organized thrombus. Eleven months after surgery the patient is doing well.- - - - - - - - - - ranking = 1147.9342705909keywords = artery (Clic here for more details about this article) |
10/1152. Tissue response of a small saccular aneurysm after incomplete occlusion with a Guglielmi detachable coil.A 49-year-old woman had a small saccular aneurysm that was incompletely occluded with a Guglielmi detachable coil (GDC). She died from rupture of another aneurysm 42 days after the treatment. autopsy for the embolized aneurysm revealed no neoendothelium at the aneurysmal neck, but an organized thrombus was observed limited to the periphery of the aneurysmal lumen. Although isolation of the aneurysm was not apparent, loose embolization with this method may help to reinforce the aneurysmal wall.- - - - - - - - - - ranking = 803577.85393294keywords = aneurysm (Clic here for more details about this article) |
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