1/227. Aortic dissection in young patients with chronic hypertension.We describe four patients aged 14 to 21 years who developed acute aortic dissection. In three of the four patients, the course was fatal, despite aggressive medical and surgical intervention. All four patients had sustained systemic hypertension related to chronic renal insufficiency. The patients had no other identifiable risk factors for aortic dissection, including congenital cardiovascular disease, advanced atherosclerosis, vasculitis, trauma, pregnancy, or family history of aortic dissection. Although aortic dissection is rare in individuals younger than 40 years of age, young patients with sustained systemic hypertension are at increased risk for this serious and often fatal condition. physicians must be aware of this rare complication of hypertension and consider aortic dissection in the differential diagnosis of unusual chest, abdominal, and back pain in hypertensive children, adolescents, and young adults.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/227. fibromuscular dysplasia involving coronary arteries--a case report.The authors report a young patient with fibromuscular dysplasia involving multivessels including coronary arteries. If young patients have chest pain on effort, fibromuscular dysplasia of coronary arteries must be considered. As fibromuscular dysplasia is a chronic progressive disease and some cases progress rapidly in a few months, careful follow-up and comprehensive medical management may be necessary in such patients.- - - - - - - - - - ranking = 2.3908784162971keywords = chest pain, chest (Clic here for more details about this article) |
3/227. Papillary endothelial hyperplasia presenting as a chest wall neoplasm.Soft tissue hematomas generally resolve but may persist and develop into slow-growing, organized masses. These chronic expanding hematomas are characterized by a pseudocapsule and a predominantly necrotic central cavity, with foci of newly formed capillaries. These have been called chronic expanding hematomas or Masson's papillary endothelial hyperplasia. These lesions can mimic vascular neoplasms and must be considered in the evaluation of expanding soft tissue vascular malformations.- - - - - - - - - - ranking = 4keywords = chest (Clic here for more details about this article) |
4/227. Treatment of a large congenital coronary fistula with coil embolization.A 77-year-old woman suffering from progressive dyspnea and chest pain for 2 1/2 years was admitted to hospital. There were no ECG changes at exercise test and a dobutamine stress echocardiography was normal. At catheterization, right-sided pressures were within normal limits. coronary angiography revealed a congenital coronary fistula, 3-4 mm in diameter, from the left anterior descending artery to the proximal pulmonary artery. There was no significant rise in blood oxygen saturation in the pulmonary artery. Transcatheter coil embolization was performed in the distal part of the tortuous fistula. Flow ceased within minutes, demonstrating the feasibility and efficacy of this technique for treating large fistulas.- - - - - - - - - - ranking = 2.3908784162971keywords = chest pain, chest (Clic here for more details about this article) |
5/227. Disseminated nocardiosis in a bone marrow transplant recipient with chronic GVHD.We describe a case of disseminated nocardiosis in a 53-year-old male allogeneic marrow recipient with chronic GVHD, 15 years post BMT. Six months prior to admission he was treated for recurrent chronic GVHD with corticosteroids with a good response. He deteriorated subsequently while still on steroids requiring admission for fever, anorexia, weight loss, productive cough and progressive dyspnoea. On admission he had multiple nodular lesions on chest roentgenogram and subsequently grew nocardia farcinica in blood culture. N. farcinica is rare post BMT, has a high mortality, is resistant to various antibiotics and needs prolonged antimicrobial therapy. We report the successful management of our patient with single agent trimethoprim-sulphamethoxazole.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
6/227. Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis.A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
7/227. Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy.MRI was performed on the spinal roots, brachial and lumbar plexuses of 14 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). hypertrophy of cervical roots and brachial plexus was demonstrated in eight cases, six of whom also had hypertrophy of the lumbar plexus. Of 11 patients who received gadolinium, five of six cases with hypertrophy and one of five without hypertrophy demonstrated enhancement. All patients with hypertrophy had a relapsing-remitting course and a significantly longer disease duration. Gross onion-bulb formations were seen in a biopsy of nerve from the brachial plexus in one case with clinically evident nodular hypertrophy. We conclude that spinal root and plexus hypertrophy may be seen on MRI, particularly in cases of CIDP of long duration, and gadolinium enhancement may be present in active disease.- - - - - - - - - - ranking = 6.2199846068606keywords = plexus (Clic here for more details about this article) |
8/227. Diffuse panbronchiolitis, the first case reports in thailand.Diffuse panbronchiolitis (DPB) is an important cause of progressive obstructive lung or chronic suppurative lung disease in the far east (japan, china and korea). It is a distinctive sinobronchial syndrome with typical radiological and histologic features. We have identified three patients who have typical clinical manifestation and pathological confirmation. DPB should be suspected in patients who have clinical manifestations of chronic cough, productive sputum and shortness of breath. The chest radiograph often shows diffuse nodular shadows on a background of hyperinflated lungs. High resolution computed tomographic (HRCT) can guide the diagnosis and differentiate from other diseases. Finally, the most important issue of DPB is the treatment. Chronic treatment with low-dose erythromycin can improve the survival of patients.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
9/227. Chronic cough due to bronchobiliary fistula.Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was confirmed by percutaneous transhepatic cholangiography. drainage of the intrahepatic biliary tract resulted in complete resolution of her symptoms.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
10/227. Unsuspected aortic dissection: the chronic "healed" dissection.Of all aortic dissections, 10% are chronic. Typically they arise distal to the left subclavian artery and have reentry points into the true lumen. Pain may be minimal or absent and patients often present with cardiac failure. Chronic dissections are more likely to appear radiographically as atherosclerotic aneurysms on a chest film than are acute dissections. Four cases of chronic dissections found incidentally during angiography are presented.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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