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

Hemostatic effect is achieved most efficiently by bipolar electrocoagulation in the neurosurgical operation. As far as function is concerned, the laser surgical unit closely resembles the electrosurgical unit. It has been possible to unite arterial vessel ends in a very fast procedure by means of heat application with the laser or bipolar electrocautery. The authors studied the difference between the CO2 Laser and Bipolar Electrocautery Effects on coagulation and anastomosis of vessels experimentally. 46 rats weighing 200gm to 250gm, were used in this study. We divided the experimental animals into 4 groups : 1) arterial coagulation with the CO2 laser, 2) vessel coagulation with the bipolar electrocautery, 3) arterial anastomosis with the CO2 laser, 4) arterial anastomosis with the bipolar electrocautery. The CO2 laser was operated at 10 watts(W) to 50W for vessel coagulation, and 2W for arterial anastomosis. The output of bipolar generation(Malis type) varied from 10 to 80 dial setting (DS) for vessel coagulation or arterial anastomosis. The results obtained were as follows : 1) The lower limit of proper arterial coagulation by the CO2 laser was 20W, 3 seconds(sec) of exposure time with defocused beam. 2) The arteries were properly coagulated with the bipolar coagulator under the DS 30~40, coagulation time 2~4 sec. Over DS 50, the artery perforated to active bleeding. 3) The veins were coagulated satisfactorily under DS 20~30 with 1~5sec. of coagulation time. 4) Both temporary cease of blood flow and using blunt bipolar forceps reduced the coagulation time, and the arteries were not performed over DS 50. 5) Arterial anastomosis was accomplished with 2W, 0.05sec of exposure with 0.2mm of focused CO2 laser beam. With the bipolar coagulator, the arteries could be anastomosed under DS 5~10, 2~3sec. of coagulation time. 6) The patency rate after arterial anastomosis was 71% with the CO2 laser and was 22% with the bipolar coagulator. 7) In the histological examination of coagulated arteries, the entire layers of laser irradiated side revealed destruction and constriction of adventitia and media sparing intima on all around the vessel wall. Anastomosed site revealed coaptation of adventitia and media.
Adventitia ; Animals ; Arteries ; Constriction ; Electrocoagulation* ; Hemorrhage ; Hot Temperature ; Lasers, Gas* ; Rats ; Surgical Instruments ; Veins

Raynaud's syndrome causes discolorization, ischemic claudication(pain) and necrosis of the digits through insufficiency in the circulation which is induced by intermittent spasms of the digital arteries. From January, 2002 to December, 2004, 10 patients were surgically treated for Raynaud's syndrome. 9 patients were female and 1 patient was male. 2 patients showed unilateral involvement, 8 patients were operated on both hands. 6 patients had necrotic changes on the finger tips due to the disease. Ages ranged from 21 to 60 with an average of 39.1. Ischemic pain, discolorization, and cold intolerance of the digits were the common symptoms. All patients were evaluated with color doppler before the surgery. Two different procedures were applied according to the severity of the disease: Patients with decreased circulation received, what we call a limited digital sympathectomy, i.e. stripping of the adventitia of the ulnar, radial and common digital arteries. An extended procedure, radical digital sympathectomy, was performed on patients with a complete block of circulation. Stripping of the adventitia in these patients also involved the proper digital arteries. Symptoms like discolorization, ischemic pain, and cold intolerance improved immediately after the surgery. The patients did not suffer from pain even with exposure to cold weather. We conclude that digital sympathectomy could improve the symptoms in Raynaud's patients who do not respond to conservative treatment such as calcium channel blocker and other vasodilators.
Adventitia ; Arteries ; Calcium Channels ; Female ; Fingers ; Hand ; Humans ; Male ; Necrosis ; Spasm ; Sympathectomy* ; Vasodilator Agents ; Weather

A rare case of multiple mixed endocrine-exocrine carcinoma (MEEC) of gallbladder in a 68-year-old man is described. The lesions were two separate nodules (17x13x7 mm and 17 mm in length) on the mucosa, which were composed of predominant neuroendocrine carcinoma (NEC) infiltrating into the adventitia and minor portion of adenocarcinoma (AC) or high grade dysplasia (HGD) on the surface. Surrounding mucosa showed areas of low grade dysplasia (LGD). Two nodal metastases out of 16 nodes were found containing NEC component. By immunohistochemistry, human mutL homolog 1 (hMLH1), p53, human mutS homolog 2 (hMSH2) and human mutS homolog 6 (hMSH6) showed diffuse strong positive reaction in HGD, AC and NEC, contrasting with weak positive reaction in LGD. On genetic analysis, all lesions of HGD, AC, and NEC except for LGD showed positive loss of heterozygosity in D5S346 locus. For microsatellite instability and K-ras mutation tests, all lesions showed negative results. Common immunophenotypes and molecular results among HGD, AC, and NEC suggested that NEC of this MEEC was derived from the dysplasia-AC sequence.
Adenocarcinoma ; Adventitia ; Aged ; Carcinoma, Neuroendocrine ; Gallbladder ; Humans ; Immunohistochemistry ; Loss of Heterozygosity ; Microsatellite Instability ; Mucous Membrane ; Neoplasm Metastasis

Fibrosclerosing periaortitis is a rare condition that refers to a spectrum of idiopathic diseases characterized by a fibroinflammatory reaction that extends from the adventitia of the aorta into the surrounding structures. It can be present in either IgG4-related or non-IgG4-related fibrosclerosing periaortitis. IgG4-related fibrosclerosing periaortitis could be associated with concomitant multi-organ involvement. However, non-IgG4-related fibrosclerosing periaortitis has rarely been associated with systemic manifestations. Here, we report a 76-year-old female with non-IgG4-related fibrosclerosing periaortitis, who developed pancytopenia, pleural effusion and ascites, which improved after high dose steroid treatment.
Adventitia ; Aged ; Aorta ; Ascites ; Female ; Humans ; Immunoglobulin G ; Pancytopenia ; Pleural Effusion ; Retroperitoneal Fibrosis

Adventitial cystic disease (ACD) of venous system is an extremely rare condition. Very few reports of ACD in venous system have been described. In this report we discuss two cases of common femoral vein ACD that presented with a swollen leg by the obstruction of the vein. Ultrasound imaging showed the typical hypoechoic fluid filled cyst with a posterior acoustic window. Computed tomography scan and ascending venogram showed a stenosis to flow in the common femoral vein caused by an extrinsic mass. Trans-adventitial evacuation of cyst with removal of vein wall was performed for both cases. During operation we found the gelatinous material in the cysts arising in the wall of the common femoral vein and compressing the lumen. The patients were released after short hospitalization and have remained symptom free with no recurrence.
Acoustics ; Adventitia ; Constriction, Pathologic ; Femoral Vein ; Gelatin ; Hospitalization ; Humans ; Leg ; Recurrence ; Veins