1/132. Pseudoaneurysm of the left ventricle after isolated pericarditis and staphylococcus aureus septicemia.Left ventricular pseudoaneurysm after isolated pericarditis as a result of Staphylococcal septicemia is very rare. A case of a very young patient is described. diagnosis is made by echocardiography. Immediate surgical resection of the pseudoaneurysm is the therapy of choice.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
2/132. Mycotic aneurysm complicating staphylococcal endocarditis.OBJECTIVE: To emphasize the role of noninvasive diagnostic investigative methods and their importance in early detection of mycotic aneurysm related to staphylococcal endocarditis, and of monitoring therapy or identifying complications. patients AND methods: Two patients with mycotic aneurysm that developed as complications of staphylococcal endocarditis are presented. The first patient had mesenteric artery mycotic aneurysm and presented with sudden rupture one month after initial diagnosis of mitral valve infective endocarditis and completion of a full course of antimicrobial therapy. The second patient had multiple cerebral mycotic microaneurysms and presented with hemorrhagic cerebral embolization from aortic valve infective endocarditis. RESULTS: The first patient died because of ischemic cerebral edema 48 h after rupture of the mesenteric artery mycotic aneurysm and massive hemoperitoneum, which was treated surgically with distal ileal resection and ileostomy. The second patient was alive two years after prolonged antimicrobial therapy and aortic replacement to treat moderate aortic regurgitation and progressive left ventricular enlargement. CONCLUSIONS: Mycotic aneurysm is a rare complication of infective endocarditis but has a high mortality rate because of its early or late potential catastrophic rupture. diagnosis by noninvasive diagnostic imaging techniques of mycotic aneurysm before rupture would be beneficial for its treatment.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
3/132. Treatment of osteomyelitis by antibiotic impregnated porous hydroxyapatite block.A novel drug delivery system was developed for osteomyelitis using porous hydroxyapatite blocks (HA-b) that were impregnated with antibiotics by a centrifuge method. For the experimental study, a 10 mm3 HA-b was placed in a container, mixed with an antibiotic solution and centrifuged at 1500 rpm for 15 min for the purpose of impregnating antibiotics into the pores. The slow release activity of antibiotic (Arbekacin sulfate [1-N-(S)-4 amino-2-hydroxybutyryl dibekacin]) from the HA-b was tested. An evaluation was made of the slow-releasing capabilities of the ABK from HA-b which was still maintained at 0.5 microgram/ml within 21 exchanges of PBS after 42 days. Consequently, seven patients with osteomyelitis, including one with tuberculosis and two with infected hip arthroplasty, have been treated. On a follow-up study, all of the foci had completely healed by the end of the follow-up period without complications. This new method is simple and can be performed safety as a one-stage operation.- - - - - - - - - - ranking = 9.9772937468315keywords = delivery (Clic here for more details about this article) |
4/132. Reconstructive treatment of sclerosing osteomyelitis of the entire femur of 30 years' duration with avoidance of segmental resection.We describe the successful operative treatment of a patient with chronic sclerosing osteomyelitis of the femur in which en bloc resection was avoided. Therapy consisted of combined endoscopic, computed tomography and bone scan-guided fenestration and intramedullary reaming, with removal of all sclerotic zones and normalization of the cortical thickness. An adequate supply of oxygen to the area was ensured by improved vascularisation and the application of hydrogen peroxide. At the medium term follow-up no recurrence was seen, and hip and knee function was normal.- - - - - - - - - - ranking = 5keywords = section (Clic here for more details about this article) |
5/132. Left ventricular pseudoaneurysm complicating infective pericarditis.Cross sectional echocardiography demonstrated a pseudoaneurysm of the left ventricular posterolateral wall close to the atrioventricular junction in a 4 year old girl with infective pericarditis complicating lobar pneumonia. Colour flow Doppler demonstrated bidirectional flow across the communication hole. Surgical resection was successful.- - - - - - - - - - ranking = 2keywords = section (Clic here for more details about this article) |
6/132. thrombosis of a mitral valve prosthesis resulting from staphylococcus epidermidis endocarditis.A 70-year-old man with a Duromedics mitral valve prosthesis had two episodes of infective endocarditis caused by enterococcus (1994 and 1996). colonoscopy revealed five polyps. Surgical resection was performed and 2 days later the patient had dyspnea and fever. Because of a suspected valve thrombosis, intravenous heparin was given which resulted in hematic effusion in the Douglas' cul-de-sac. Intravenous heparin was withdrawn but the patient continued to have a worsening dyspnea, hyperthermia and hypotension. The patient was transferred to our Institution in cardiogenic shock. Acute thrombosis of the valve was diagnosed by echocardiography, and the patient died before transesophageal Doppler echocardiography was performed. Post mortem examination revealed mitral valve infective thrombosis. In patients with valvular prostheses, endocarditis is an added thromboembolic risk.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
7/132. Video-assisted tricuspid valve surgery: a new surgical option in endocarditis on pacemaker.A patient presenting with a pacemaker lead infection and tricuspid regurgitation underwent a minimally invasive video-assisted tricuspid valve replacement. The valve was approached through a right anterior mini thoracotomy. Under thoracoscopic vision and peripheral cardiopulmonary bypass, a catheter was placed on the ascending aorta for antegrade cardioplegia delivery. A transthoracic aortic cross-clamp was introduced through the third right intercostal space. tricuspid valve replacement added to the pacemaker leads ablation was exclusively performed under thoracoscopic vision, providing an excellent video-image in this reduced operative field. After 22 months of follow up, the patient is asymptomatic, the echocardiography showing a normally functioning valve.- - - - - - - - - - ranking = 9.9772937468315keywords = delivery (Clic here for more details about this article) |
8/132. Descending necrotizing mediastinitis with sternocostoclavicular osteomyelitis and partial thoracic empyema: report of a case.We present herein the case of a 50-year-old woman in whom descending necrotizing mediastinitis originating from an anterior neck abscess spread to the left upper bony thorax, resulting in osteomyelitis of the left sternocostoclavicular articulation and left partial thoracic empyema. Transcervical mediastinal irrigation and drainage was performed with aggressive antibiotic therapy, followed by resection of the left sternocostoclavicular joint and debridement of the anterior mediastinum. The patient had an uneventful postoperative course, and her left arm and shoulder mobility was well preserved.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
9/132. Diffuse chronic sclerosing osteomyelitis and the synovitis, acne, pustolosis, hyperostosis, osteitis (SAPHO) syndrome in two sisters.Two sisters with diffuse chronic sclerosing osteomyelitis of the mandible and the humerus and the synovitis, acne, pustolosis, hyperostosis and osteitis syndrome (SAPHO syndrome) are presented. The diagnoses of diffuse chronic sclerosing osteomyelitis at the age of 12 years and 27 years, respectively, were based on typical medical history, clinical symptoms and radiographic, histologic and scintigraphic findings. Because skin lesions and scintigraphic enhancement of the sternoclavicular joints with hyperostosis were present, a SAPHO syndrome was diagnosed in both sisters. Microbiological cultures of biopsy specimens revealed coagulase-negative staphylococcus aureus at the humerus and haemophilus parainfluenzae, streptococcus, actinomyces and Veilonella species at the mandible. Repeated operative procedures, including decortications, resection and reconstruction, and multiple histologic and microbiologic studies were performed over a period of up to 20 years. Since HLA typing yielded identical gene loci, we suggest that hereditary and autoimmune factors may play a role in the pathogenesis of these cases.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
10/132. Diagnostic and therapeutic vitrectomy for endophthalmitis.The introduction of a compact portable vitreous suction cutter enables the aspiration and resection of infected ocular tissues for diagnostic and therapeutic purposes. Four cases of postoperative bacterial endophthalmitis are presented in which mechanical anterior vitrectomy was performed in addition to conventional antimicrobial therapy. Three of these eyes were saved and 2 retained the possibility of useful vision. A rationale for the aggressive managements of endophthalmitis is presented.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
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