Adventitia ; Humans ; Mitral Valve ; Mitral Valve Prolapse

Retrorectal cystic harmatoma; Tailgut cyst, is a rare congenital disease typically presented as presacral mass, and malignant change of this disease is extremely rare. Frequently, This disease is misdiagnosed or confused at initial time. So, we have a case of tailgut cyst and report the clinical symptom and the result. A 40-year-old woman has admitted at Severance hospital for the anal pain. About 6cm sized irregular cystic and solid mass in the retrorectal area involving coccygeal bone and right gluteal muscle tendon were detected in magnetic resonance image. Under the impression of malignant tailgut cyst, the patient underwent Hartmann's operation (abdomino-sacral approach) under the sacral resection (S4, 5). The pathology was adenocarcinoma (poorly differentiated) arising from a tailgut cyst involving rectal adventitia, gluteus muscle and sacral bone. For the following 4 months after the operation, The patient is doing well with no evidence of recurrence.
Adenocarcinoma* ; Adult ; Adventitia ; Female ; Humans ; Pathology ; Recurrence ; Tendons

adventitia was not stripped at microvascular anastomoses (n=4); in Sharp stripping group, adventitia stripped by sharp stripping method using microscissors and Jeweler's forceps (n=4); and in Blunt stripping group, adventitia stripped by blunt stripping using two Jeweler's forceps (n=4). The patency was evaluated by empty-and-refill test immediately, 30 minutes and 3 days after microvascular anastomoses. Thrombus formation was evaluated by the microscopic examination 3 days after microvascular anastomoses and the histological examination was done around the anastomosed site. Thirty minutes after microanastomoses, the patency of both Sharp and Blunt stripping groups was better than that of Control group, but there was no statistically significant difference in patency among 3 groups. Three days after microanastomoses, the patency of both Sharp and Blunt stripping group was better than that of Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. Compared with 30 minutes after anastomoses, the patency of Sharp stripping group was still good 3 days after anastomoses, but the patency of Blunt stripping was slightly decreased and that of Control group was worst among groups. Three days after microanastomoses, the amount of thrombus in both Sharp and Blunt stripping groups was less than in Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. In histologic examination, the amount of thrombus in the lumen and the ingrowth of adventitia into the lumen in Sharp and Blunt stripping groups were less than that in Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. In conclusion, these results suggest that arterial stripping is effective in microvascular anastomoses and the sharp stripping method is better than the blunt stripping method.]]>
Adventitia ; Animals ; Femoral Artery ; Rabbits ; Surgical Instruments ; Thrombosis

Humans ; Prevalence ; Mitral Valve ; Mitral Valve Prolapse ; Adventitia

Humans ; Prevalence ; Mitral Valve ; Mitral Valve Prolapse ; Adventitia

In this study, we describe our diagnosis and treatment of two patients who presented with femoral vessel compression caused by a cystic lesion in the groin. One case was diagnosed as adventitial cystic disease (ACD) of the common femoral artery resulting in leg claudication and the other was diagnosed as a ganglion cyst (GC) causing femoral vein compression and unilateral leg swelling. The operative findings differed between these two cases with respect to the dissection of the cyst and femoral vessel, but the postoperative histological examination results were similar. The pathogenesis of ACD and GC is not fully understood, and further investigation is needed to delineate the exact pathology of these uncommon conditions.
Adventitia ; Diagnosis ; Femoral Artery ; Femoral Vein ; Ganglion Cysts ; Groin* ; Hip ; Humans ; Leg ; Pathology

A goblet cell appendiceal carcinoid (GCAC) is an uncommon tumor. It shares the histologic features of both adenocarcinoma and conventional carcinoids. The metastatic potential of GCAC is higher than that of classic appendiceal carcinoids. Their management, whether an appendectomy alone is an adequate treatment or whether a right hemicolectomy is indicated, is still under debate. The metastatic potential of GCAC is similar to that of classic appendiceal carcinoids and depends on the tumor size and the mitosis rate. Therefore, some authors advocate a simple appendectomy, not expanding beyond the appendix adventitia, for selected patients with tumors less than 1 cm in diameter with a low mitosis rate (<2/10 HPF). Otherwise, a right hemicolectomy is indicated for all other patients to reduce the risk of developing metastatic disease. Chemotherapy is the usual treatment option for metastatic disease, but more data are required if an optimal regimen is to be determined. Finally, colonoscopy plays an important role in patients with an appendiceal adenocarcinoid because of their high risk of developing a colorectal adenocarcinoma. Recently, we discovered one case of a GCAC that was diagnosed incidentally at appendectomy. A 48-yr-old man visited the emergency department with the symptom of right lower quadrant abdominal pain. Acute appendicitis was suspected after evaluation, and a laparoscopic appendectomy was performed. The type of appendicitis was gangrenous, and there were no obvious signs of malignancy. However, a pathologic diagnosis of a goblet cell carcinoid was made. A laparoscopic right hemicolectomy was subsequently performed. The patient received 5 cycles of chemotherapy applied to the goblet cell carcinoid and has shown no other remarkable indispositions during the last 12 mo.
Abdominal Pain ; Adenocarcinoma ; Adventitia ; Appendectomy ; Appendicitis ; Appendix ; Carcinoid Tumor ; Colonoscopy ; Emergencies ; Goblet Cells ; Humans ; Mitosis

BACKGROUND: Although arterial grafts are widely used due to the advantage of long-term patency in coronary bypass surgery, greater saphenous vein is still an important additional conduit. It was reported that preservation of the adventitia of vein graft and the adjacent tissues may bring the improved long-term graft patency. The aim of this study is to look for a harvest technique that can reduce vein injury and wound complications. MATERIAL AND METHOD: In thirty-four patients that vein grafts were used for coronary bypass surgery, 50 harvest sites were included for the study. In 25 harvest sites in calf below knee (group 1), vein was exposed through a long incision and then clearly dissected from the adjacent tissue. Ten endoscopic vein harvests were performed in the thighs (group 2). Fifteen other vein grafts that were bluntly dissected were harvested from the thighs through three separate incisions (group 3). RESULT: Vein harvest time was longest in endoscopic harvest group (44.7+/-9.8 minutes) and shortest in group 3 (24.2+/-5.9 minutes) (p=0.000). Most avulsion injuries of vein branches happened in the endoscopic group. Sequential grafting numbers per vein were 1.72+/-0.98 with thigh vein graft and 1.16+/-0.37 with calf vein (p=0.02). Swelling of foot and/or leg, which was the most common wound complication after vein harvest, was most commonly presented in group 1 (20/25 sites; p=0.000). Tingling, the most common neurologic complication, was also most prevalent in group 1 (7/25 sites; p=0.013). The risk factor of the wound complication was vein harvest from calf, and the vein harvest technique was not a risk for wound complication. CONCLUSION: Vein harvest technique through three separate incisions from thigh presented shorter harvest time and less vein injury and wound complication compared with the endoscopic harvest technique from thigh or the harvest through a long incision from calf.
Adventitia ; Foot ; Humans ; Knee ; Leg ; Risk Factors ; Saphenous Vein* ; Thigh ; Transplants ; Veins* ; Wounds and Injuries*

A pseudoaneurysm is a collection of blood that locates between the two outer layers of an artery, the muscularis propria and the adventitia. It is resulted from disruption of a portion of the arterial wall. A pseudoaneurysm can be caused by trauma, blood vessel intervention, intravenous drug use, vasculitis, infectious aneurysm, and postoperative anastomotic leakage. The pseudoaneurysm of superior thyroid artery after core needle biopsy is rare. We report a case of pseudoaneurysm caused by thyroid core needle biopsy and treated by surgical treatment.
Adventitia ; Anastomotic Leak ; Aneurysm ; Aneurysm, False* ; Arteries* ; Biopsy, Large-Core Needle* ; Blood Vessels ; Thyroid Gland* ; Vasculitis

Esophageal tuberculosis is a rare disease that is difficult to diagnose with esophagogastroduodenoscopy (EGD), endoscopic ultrasonography (EUS), and computerized tomography. The patients with esophageal tuberculosis show diverse endoscopic findings, but ulcerative lesion in the middle esophagus is usually found. In Korea, the endoscopic ultrasonographic findings of esophageal tuberculosis have not been described. The main endoscopic ultrasonographic findings of esophageal tuberculosis include heterogeneous or homogeneous hypoechoic masses in the esophageal wall with hyperechoic spots inside, interruption of the esophageal adventitia, and mediastinal lymphadenopathy. In this report, we describe two patients with esophageal tuberculosis, and they presented with submucosal tumor. In these patients, esophageal tuberculosis was diagnosed by EGD, EUS, and performing tuberculosis phase chain reaction on the endoscopic biopsies.
Adventitia ; Biopsy ; Endoscopy, Digestive System ; Endosonography ; Esophagus ; Humans ; Korea ; Lymphatic Diseases ; Rare Diseases ; Tuberculosis ; Ulcer