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

Takayasu,s arteritis is a systemic disease characterized by occlusion of aorta and its major branches because of a panaortitis with thickening of the adventitia. Coronary artery narrowing is due to extension of inflammations that occur in aorta. Angina pectoris may be the first symptom of the disease if the coronary arteries are the initial site of severe arterial narrowing. We present a case of bilateral coronary ostial stenosis where Takayasu,s arteritis was pathologically proved as an etiology. The patient was taken coronary ostial angioplasty with good result.
Adventitia ; Angina Pectoris ; Angioplasty ; Aorta ; Arteritis ; Constriction, Pathologic* ; Coronary Vessels ; Humans ; Inflammation ; Takayasu Arteritis*

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

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

It is recommened to remove the arterial adventitia from the vessel ends to prevent adventitial interpose between the edges of anastomoses vessels. We have analysed the effect of adventitial removal on the patency in microvascular anastomosis. using rat femoral artery Three groups of adventitial removal methods were studied: non-removal group, sharp dissection group and blunt dissecction group. Patency was evaluated one hour, 24hours and 7days after anastomosis. The patency rate of non-dissection group(n=40) was 90% one hour after anastomosis but it reduced to 62.5% both at 24 hours and at 7days because interpositioning of adventitia induced thrombosis. The blunt skipping group showed 62.5% of patency rate at one hour most likely due to vascular spasm, but after 24hours it was recovered to 80% and 78.5% at 7th day. The sharp dissection group showed persistently high patency rate of 97.5% after one hour,95% both after 24 hours and after 7 days. Scanning electron microscopy showed endothelial loss and medial edema in bluntly stripped vessels but it showed well preserved endothelial cells and medial wall in sharp dissection group. The reason of relatively low patency rates of blunt dissection group compared with sharp dissection group 24 hours and 7 days after anastomosis(p=0.043 and p=0.023, respectively) was endothelial damage induced by stretching force made during blunt stripping.
Adventitia ; Animals ; Edema ; Endothelial Cells ; Femoral Artery ; Microscopy, Electron, Scanning ; Rats ; Spasm ; Thrombosis