No abstract available.
Child* ; Humans ; Prone Position* ; Thoracotomy*

No abstract available.
Myxoma*

Subglottic stenosis is more likely to develop secondary to endotracheal intubation if one or more traumarelated risk factors are involved. Subglottic stenosis have been dealt with many medicosurgical procedures such as dilatation, stent, laryngofissure with or without skin of mucosal graff, and segmental resection. We report longterm failure of expandable metallic stent in the treatment of subglottic tracheal steno$is in 4 cases which had been presented with respiration difficulty due to framework problem of subglottic trachea after surgical operation.
Constriction, Pathologic ; Dilatation ; Intubation, Intratracheal ; Respiration ; Risk Factors ; Skin ; Stents* ; Trachea ; Tracheal Stenosis*

The residual tense false lumen following surgical repair of aortic dissection remains one of the most difficult and challenging postsurgical problems. Percutaneous fenestration of the dissecting membrane under the guidance of intravascular ultrasound has been recently introduced to depressurize the tense false lumen. A 63-year-old woman who underwent repair of acute type I dissection was readmitted because of claudication and numbness of the left lower extremity. Angiography, computed tomography, and magnetic resonance imaging clearly showed a dissection flap starting from the thoracic aorta distal to the left subclavian artery. Compressed true lumen by the markedly enlarged tense false lumen was also noted in the double-channeled descending thoracoabdominal aorta. Under intravascular ultrasound guidance, the intimal flap was punctured with a Brockenbrough needle advanced to the true lumen through a femoral artery, and then, a balloon catheter was introduced over the guidewire which was placed across the dissection flap. Desired fenestration was obtained successfully by inflation of the balloon without complications. After procedure, symptoms resolved promptly and she is currently(clinical follow-up of 12 months postfenestration) ambulating without claudication. In conclusion, percutaneous fenestration of the intimal flap is a technically feasible and an effective alternative procedure to surgical repair for restoration of perfusion to an ischemic extremity in selected patients complicated with aortic dissection.
Angiography ; Aorta ; Aorta, Thoracic ; Catheters ; Extremities* ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflation, Economic ; Ischemia* ; Lower Extremity ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Needles ; Perfusion ; Subclavian Artery ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography

No abstract available.
Stents*

Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*

BACKGROUND: The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. METHODS: In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-based procedure in 10 patients. RESULTS: Initially, there was no significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting for LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis (diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31 +/- 25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). CONCLUSION: Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.
Angiography ; Catheters ; Constriction, Pathologic ; Coronary Vessels* ; Follow-Up Studies ; Hospital Mortality ; Humans ; Hypotension ; Myocardial Infarction ; Retrospective Studies ; Stents*

BACKGROUND AND OBJECTIVES: This prospective single-center randomized clinical study was designed to evaluate the long-term angiographic and clinical outcomes of elective treatment using the Crossflex (coil stent) as compared with the NIR (tubular stent) in patients with native coronary artery disease. SUBJECTS AND METHODS: 104 patients with 107 de novo discrete coronary stenoses were randomly assigned to the NIR stent (54 coronary stenoses) or the Crossflex stent (53 coronary stenoses). Six-month follow-up angiograms were obtained in 83 patients with 86 lesions (80%). Clinical follow up was available in all patients and the period averaged 23.1+/-5.3 months in the Crossflex group and 23.1+/-6.2 months in the NIR group. RESULTS: Procedural success was measured at 100% in both groups. There were no cases of stent thrombosis in either group. Although a higher loss index and more severe follow-up diameter stenosis occurred in the crossflex group, the angiographic restenosis rate was not significantly different in between the groups.
Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease ; Coronary Restenosis ; Coronary Stenosis ; Follow-Up Studies ; Humans ; Prospective Studies* ; Stents* ; Thrombosis

Lipoblastoma, a rare benign tumor of adipose tissue, occurs in infants and young children. The prevalent sites are chiefly the upper and the lower extremities and less commonly the head, neck, trunk, mesentery, mediastinum, and retroperitoneum. Circumscribed forms (benign lipoblastoma) are more common and superficially located. Diffuse forms (diffuse lipoblastomatosis) are more deeply situated. Prognosis is excellent after excision. The recurrence rate after surgical excision is low and tumors recur mainly in the deep diffuse type because of incomplete removal of the tumor. Therefore, wide local excision appears to be the treatment of choice. We experienced a 4-year-old boy who presented with a palpable mass on the left upper abdomen and was suspected to be a benign lipoblastoma of the retroperitoneum on computerized axial tomography. The tumor was completely excised. Final histologic examination confirmed the diagnosis of a benign lipoblastoma.
Abdomen ; Adipose Tissue ; Child* ; Child, Preschool ; Diagnosis ; Head ; Humans ; Infant ; Lipoblastoma* ; Lower Extremity ; Male ; Mediastinum ; Mesentery ; Neck ; Prognosis ; Recurrence

We experienced five cases of solitary fibrous tumor; two in the pleura, two in the orbital soft tissue, and one in the lung parenchyma. Three patients were male, and the age of the patients ranged from 38 to 71 years (mean age: 53.6). Grossly, the masses were well circumscribed and had varying sizes from 2.5 to 30.0 cm. The cut surfaces were grayish-yellow firm with focal variegated hemorrhage, necrosis, cystic change, and myxoid area. Microscopically, these were characterized by a haphazard proliferation of spindle cells or polygonal cells separated by variable amounts of hyalinized collagen and showed a prominent vascular channels reminiscent of hemangiopericytoma in foci. Immunoperoxidase stains showed a strong reactivity for CD34, and were weakly positive for vimentin. Electron microscopical examination revealed features of fibroblast; spindle to round tumor cells were arranged in groups and surrounded by collagen. Nucleoli were seldom prominent. The cytoplasm contained many microfilaments and a moderate number of cisternae of rough endoplasmic reticulum.
Actin Cytoskeleton ; Collagen ; Coloring Agents ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Fibroblasts ; Hemangiopericytoma ; Hemorrhage ; Humans ; Hyalin ; Lung ; Male ; Necrosis ; Orbit ; Pleura ; Solitary Fibrous Tumors* ; Vimentin