1/7. Postmortem findings two weeks after oral treatment for metastatic candida endophthalmitis with fluconazole.The purpose of this histological study was to present postmortem findings in both eyes of a 53-year-old male with liver dysfunction 2 weeks after short-time oral treatment with 200 mg/day fluconazole for metastatic candida endophthalmitis due to intravenous hyperalimentation for 18 days. candida had been demonstrated in the venous blood and on the tip of the intravenous catheter. The bilateral fungal endophthalmitis with hypopyon responded well to fungistatic therapy, but the patient suddenly died from heart failure. Both eyes were obtained at autopsy. candida was demonstrated only in vitreous puff balls but not in the retina or uvea. fluconazole administered for a short period had little effect in eliminating fungus from vitreous puff balls, which have no blood supply. Prolonged administration of the antifungal drug or vitrectomy should be considered when treating an eye with vitreous puff balls in the presence of fungal endophthalmitis.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
2/7. Anaesthetic management of a patient with microvillus inclusion disease for intestinal transplantation.We report the anaesthetic management of a 3-year-old-child with microvillus inclusion disease undergoing isolated small bowel transplantation. He required long-term total parenteral nutrition which was complicated with numerous episodes of catheter related sepsis. This resulted in thrombosis of the major blood vessels which critically restricted vascular access available for intravenous nutrition, becoming a life-threatening condition for the patient. Haemodynamic, respiratory parameters and urinary output were well preserved throughout the procedure. Besides a transitory increase in potassium following graft revascularization, biochemical changes were small. Anaesthetic management included comprehensive preoperative assessment, central venous angiography to depict accessibility of central and peripheral veins, assurance of additional vascular access through the intraoperative catheterization of the left renal vein, perioperative epidural analgesia and preservation of splanchnic perfusion to ensure implant viability.- - - - - - - - - - ranking = 2keywords = catheter (Clic here for more details about this article) |
3/7. Simultaneous occurrence of a thyromediastinal muscle, a truncus bicaroticobrachialis, and a left superior vena cava.A case is presented of a combination of anatomical anomalies found in a 67-year-old female cadaver during routine dissection by medical students. They include a thyromediastinal muscle, a truncus bicaroticobrachialis, and a left superior vena cava, with complete absence of the right superior vena cava, but with a normal azygos vein opening into the right atrium at the expected site of entry of the superior vena cava. No associated congenital cardiac malformations were found. Clinical implications include the difficulty of heart catheterization through the subclavian veins and misleading images on CT or MRI scans, where the azygos vein could be mistaken for a right superior vena cava.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
4/7. Post-mortem observations of a recent radiofrequency catheter ablation site.The acute and chronic gross and microscopic morphologic changes present in myocardium after radiofrequency catheter ablation have been previously described in animal experiments. Acute changes have also been described in four cadaveric human specimens. We describe post-mortem observations of a recent radiofrequency catheter ablation site in a patient who underwent successful ablation for refractory ventricular tachycardia. Our gross and microscopic observations are similar to those previously described in animal experiments and confirm that the animal experimental results can be extrapolated to human hearts. As the use of radiofrequency becomes more prevalent as an alternative treatment for refractory cardiac tachycardias, pathologists will be called upon to identify post-mortem the lesions described. These lesions can be specifically identified, which can serve as a useful verification for this procedure.- - - - - - - - - - ranking = 6keywords = catheter (Clic here for more details about this article) |
5/7. Management of a cadaveric orthotopic liver transplantation in a pediatric patient with complex congenital heart disease.Pediatric orthotopic liver transplantations (OLT) are commonly performed nowadays. Two primary reasons for OLT in children are complications from either extrahepatic biliary atresia (EHBA) or inborn errors of metabolism. However, congenital liver disease may be associated with significant other congenital abnormalities. We present a case of a successful OLT in a pediatric patient with a history of EHBA, situs inversus, and complex congenital heart disease. The cardiac anomalies include dextrocardia, absence of the atrial septum (single atrium), single atrioventricular valve (a-v canal), and an incomplete ventricular septum. Prior surgery include a Kasai procedure for EHBA, banding of the proximal main pulmonary artery, and Broviac catheter placement. We present the anesthesia concerns and management for this complicated case.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
6/7. Endonasal laser dacryocystorhinostomy. A new approach to nasolacrimal duct obstruction.A high-powered argon blue-green laser coupled to a 300-microns quartz fiberoptic catheter was used to create intranasal dacryocystorhinostomy fistulas in fresh-frozen cadaver heads. The procedure, which we term endonasal laser dacryocystorhinostomy, is described. cadaver specimens were examined postoperatively. Laser rhinostomies were found to involve the posteroinferior portion of the lacrimal sac fossa. tissues surrounding the fistula site showed no signs of damage. We report on the first patient to undergo endonasal laser dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction, with 10 months of follow-up. We believe endonasal laser dacryocystorhinostomy offers the following advantages over standard external dacryocystorhinostomy: (1) Tissue injury is limited to the discrete fistula site. (2) The cutaneous scar and cosmetic blemish of an external dissection are eliminated. (3) Excellent hemostasis is maintained. (4) Minimal operative and postoperative morbidity permits outpatient surgery, with faster resumption of normal daily activities and increased cost-effectiveness. (5) patients prefer endonasal laser dacryocystorhinostomy to external dacryocystorhinostomy.- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |
7/7. Posterior interosseous reverse forearm flap: experience with 80 consecutive cases.The results of an anatomic investigation performed in 40 fresh cadaver specimens and 80 consecutive clinical cases of the posterior interosseous reverse forearm flap are reported. It was observed that there is a choke anastomosis between the recurrent dorsal branch of the anterior interosseous artery and the posterior interosseous artery at the level of the middle third of the posterior forearm. ink injections through a catheter placed in the distal part of the anterior interosseous artery stained the distal and middle thirds of the posterior forearm, but the proximal third remained unstained; this secondary territory cannot be captured through the choke anastomosis between the anterior interosseous artery and the posterior interosseous artery. Intravital fluorescein injection into the distal arterior interosseous artery revealed (under ultraviolet light) that the distal third of the posterior forearm is irrigated by direct flow through the recurrent branch of the arterior interosseous artery (the traditionally called distal anastomosis of the interosseous arteries). Therefore, we can assume that the blood flow is not reversed when the so-called posterior interosseous reverse forearm flap is raised. From this point of view, this flap could be renamed as the recurrent dorsal anterior interosseous direct flap; however, the classical name is maintained for practical purposes. From the venous standpoint, the cutaneous area included in this flap belongs to an oscillating type of venous territory and is connected to the deep system through an interconnecting venous perforator that accompanies a medial cutaneous arterial branch located at 1 to 2 cm distal to the middle point of the forearm.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = catheter (Clic here for more details about this article) |