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1/1431. Managing a dropped nucleus during the phacoemulsification learning curve.

    Three patients had a pars plana vitrectomy to remove retained nuclei within 72 hours after phacoemulsification performed by a surgeon making the transition from extra-capsular cataract extraction to phacoemulsification. After vitrectomy, the nuclei were brought to the midvitreous cavity from the retinal surface with a posterior segment phacofragmenter, emulsified, and completely removed. Then, a posterior chamber intraocular lens was implanted in the sulcus through the previous cataract surgery incision and remained well centered postoperatively. postoperative complications included cystoid macular edema in 1 patient and choroidal detachment in another. No other complications were detected. Final visual acuity ranged from 20/60 to 20/30.
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ranking = 1
keywords = capsular, ocular
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2/1431. Progressive brown discoloration of silicone intraocular lenses after vitrectomy in a patient on amiodarone.

    A patient who was treated with amiodarone for 3 years developed brown discoloration of the intraocular lenses in both eyes. contrast sensitivity and blue perception were reduced in the right eye. After vitrectomy for a vitreoretinal traction syndrome in the left eye, the discoloration appeared to increase. The apparent progression may have been related to breakdown of the blood-aqueous barrier after vitrectomy. However, because the discoloration developed before surgery and was bilateral, long-term administration of amiodarone may also have played a role.
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ranking = 0.11017936598839
keywords = ocular
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3/1431. Intraoperative left ventricular perforation with false aneurysm formation.

    Two cases of perforation of the left ventricle during mitral valve replacement are described. In the first case there was perforation at the site of papillary muscle excision and this was recognized and successfully treated. However, a true ventricular aneurysm developed at the repair site. One month after operation rupture of the left ventricle occurred at a second and separate site on the posterior aspect of the atrioventricular ring. This resulted in a false aneurysm which produced a pansystolic murmur mimicking mitral regurgitation. Both the true and the false aneurysm were successfully repaired. In the second case perforation occurred on the posterior aspect of the atrioventricular ring and was successfully repaired. However, a false ventricular aneurysm developed and ruptured into the left atrium producing severe, but silent, mitral regurgitation. This was recognized and successfully repaired. The implications of these cases are discussed.
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ranking = 0.55317590498908
keywords = rupture
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4/1431. Progressive pulmonary autograft root dilatation and failure after Ross procedure.

    We present a case of progressive pulmonary autograft root dilatation and subsequent failure after a Ross procedure. The explanted autograft vessel wall revealed striking histologic findings indicative of chronic media rupture. Examination of another explanted pulmonary autograft root showed similar histologic changes, suggesting a common phenomenon in pulmonary autograft roots. It may be the cause of progressive root dilatation as observed after Ross operations.
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ranking = 0.27658795249454
keywords = rupture
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5/1431. Three ventriculoplasty techniques applied to three left-ventricular pseudoaneurysms in the same patient.

    A 59-year-old male patient underwent surgery for triple-vessel coronary artery disease and left-ventricular aneurysm in 1994. Four months after coronary artery bypass grafting and classical left-ventricular aneurysmectomy (with Teflon felt strips), a left-ventricular pseudoaneurysm developed due to infection, and this was treated surgically with an autologous glutaraldehyde-treated pericardium patch over which an omental pedicle graft was placed. Two months later, under emergent conditions, re-repair was performed with a diaphragmatic pericardial pedicle graft due to pseudoaneurysm reformation and rupture. A 3rd repair was required in a 3rd episode 8 months later. Sternocostal resection enabled implantation of the left pectoralis major muscle into the ventricular defect. Six months after the last surgical intervention, the patient died of cerebral malignancy. Pseudoaneurysm reformation, however, had not been observed. To our knowledge, our case is the 1st reported in the literature in which there have been 3 or more different operative techniques applied to 3 or more distinct episodes of pseudoaneurysm formation secondary to post-aneurysmectomy infection. We propose that pectoral muscle flaps be strongly considered as a material for re-repair of left-ventricular aneurysms.
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ranking = 0.27658795249454
keywords = rupture
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6/1431. A false-positive Seidel test after Ahmed valve insertion.

    An 80-year-old monocular man with long-standing primary open angle glaucoma underwent successful filtering surgery in his sighted right eye in 1980. He subsequently developed a cataract and had an uncomplicated clear cornea phacoemulsification with posterior chamber intraocular lens in 1996. Post-operatively, the filtration bleb remained very avascular but shallowed; the intraocular pressure increased and remained uncontrolled despite maximally tolerated medical therapy. His vision improved to 6/7.5 and automated perimetry revealed a less than 5 degrees small central island of vision. His left eye was phthisical with no light perception.
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ranking = 0.066107619593033
keywords = ocular
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7/1431. Type B aortic dissection and thoracoabdominal aneurysm formation after endoluminal stent repair of abdominal aortic aneurysm.

    Endoluminal stent graft repair of abdominal and thoracic aortic aneurysms is being performed in increasing numbers. The long-term benefits of this technology remain to be seen. Reports have begun to appear regarding complications of stent graft application, such as renal failure, intestinal infarction, distal embolization, and rupture. Many of these complications have been associated with a fatal outcome. We describe a case of acute, retrograde, type B aortic dissection after application of an endoluminal stent graft for an asymptomatic infrarenal abdominal aortic aneurysm. An extent I thoracoabdominal aortic aneurysm subsequently developed and was successfully repaired. Aggressive evaluation of new back pain after such a procedure is warranted. Further analysis of the short-term complications and long-term outcome of this new technology is indicated before universal application can be recommended.
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ranking = 0.27658795249454
keywords = rupture
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8/1431. Carotid ligation for carotid aneurysms.

    Thirty patients with subarachnoid haemorrhage due to rupture of a carotid aneurysm were treated by ligation of the common carotid artery. Two patients died as a result of the procedure, two patients developed persisting hemisphere deficit. Eight of the ten patients who developed cerebral ischemia after the operation were operated within ten days after the bleeding. At present out aim is to guide the patient safely through the first ten days after his haemorrhage and perform ligation at the end of the second week. After a follow up period of 1-8 years recurrent haemorrhage did not occur. Common carotid ligation, preferably with control of carotid artery end pressure, cerebral blood-flow and EEG is considered to be a valuable method to treat ruptured intracranial carotid aneurysm.
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ranking = 0.55317590498908
keywords = rupture
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9/1431. hemangiosarcoma of the spleen: report of a case and review of previously reported cases.

    Splenic hamangiosarcomas are rare tumors, usually discovered at autopsy. In a few instances the diagnosis was made premortem, at the time of splenectomy for spontaneous rupture. The tumors usually present with abdominal pain, left upper guadrant mass and tenderness, and occasionally with a microangiopathic type of anemia. The histogenesis of the tumor is in dispute. Some authors feel that they are degenerations of hemangiomas. Others feel that they arise de novo in the spleen. There is not proven association of thorotrast administration or vinyl chloride exposure to the development of hemangiosarcomas in the spleen. The prognosis of the tumor is uniformly poor and most of the patients surviving laparotomy have followed a uniformly fatal clinical course. In a few cases treated with chemotherapy there has been no evidence of clinical benefit. The case report in this article presented with essentially all the features enumerated above.
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ranking = 0.27658795249454
keywords = rupture
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10/1431. Splenic peliosis: a rare complication following liver transplantation.

    In this article, we report a rare case of isolated splenic peliosis in an individual who had recently undergone liver transplantation. The disorder had remained clinically and radiologically undiagnosed until he suffered a traumatic rupture of the affected organ. The relevant literature on this topic is briefly reviewed.
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ranking = 0.27658795249454
keywords = rupture
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