1/15. Nystagmus mimicking spasmus nutans as the presenting sign of bardet-biedl syndrome.PURPOSE: To investigate the nystagmus of twin brothers presenting with spasmus nutans later diagnosed as bardet-biedl syndrome. methods: The twins presented at the age of 14 months with a presumed diagnosis of spasmus nutans. They were followed clinically and with quantitative electro-oculographic eye movement recordings until the age of 6 years. RESULTS: polydactyly, truncal obesity, mild delay in cognitive development, visual acuity of 20/100, attenuated retinal vessels and pale disks, and bilaterally almost extinguished scotopic and photopic electroretinograms were found in both brothers. They had fine, fast, pendular, disconjugate, intermittent, oblique nystagmus. No head nodding was observed. CONCLUSION: As described in patients with other retinal diseases such as achromatopsia and congenital stationary night blindness, nystagmus of patients with bardet-biedl syndrome can mimic spasmus nutans.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/15. coronary artery bypass and superior vena cava syndrome.superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary artery bypasses are performed every year, there are not many reports on patients with superior vena cava syndrome who successfully undergo cardiopulmonary bypass and coronary artery grafting with an internal mammary artery as the conduit. The results of the case and alternative recommended methods are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/15. Delayed recovery of left ventricular function after recanalization of a chronic coronary occlusion.An unusually prolonged course of recovery of severely impaired left ventricular (LV) function (EF 32%) was observed in a patient after recanalization of a chronically occluded LAD. Despite persistent vessel patency, LV function remained depressed for almost 2 years after the percutaneous transluminal coronary angioplasty until complete recovery (EF 82%) could be observed. The possibility of a delayed recovery should be considered when assessing new therapeutic strategies to improve LV function of chronically ischemic myocardium.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/15. weight loss-induced calciphylaxis: potential role of matrix metalloproteinases.calciphylaxis is an uncommon and often devastating syndrome of calcification of small vessels, leading to tissue infarction. The mechanism of how calcium deposits on small vessels is unknown. Recently, metalloproteinase digestion of elastin has been shown to enhance deposition of calcium, suggesting a possible mechanism of calciphylaxis. We describe a case of a patient who developed calciphylaxis after rapid weight loss, but had normocalcemia and normal renal function. She was found to have high levels of matrix metalloproteinases, which may have chemically altered elastin, allowing deposition of calcium on small vessels. Inhibitors of matrix metalloproteinases may be useful in the prevention and treatment of calciphylaxis.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
5/15. Off-pump coronary artery bypass grafting in a high-risk dextrocardia patient: a case report.We present an interesting but high-risk case of an obese male patient aged 56 years with dextrocardia and a left diaphragmatic hernia. Anterior myocardial infarction was diagnosed in 1994, and the patient later presented with a history of unstable angina. The diagnosis for this chronic smoker was triple-vessel disease, impaired left ventricular function, chronic renal failure, chronic bronchitis, impaired lung function, pulmonary hypertension, hypertension, diabetes, and chronic active gastritis (EuroSCORE of 10). The patient underwent successful off-pump coronary artery bypass grafting with 3 saphenous vein grafts to the left anterior descending, obtuse marginal, and right posterior descending arteries. He was discharged home 8 days later.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/15. obesity: a risk factor for acute myocardial infarction with angiographically patent epicardial coronary vessels in an adolescent.OBJECTIVE: Toreport a causal relationship between myocardial infarction (MI) and obesity in an adolescent in the absence of the well-known risk factors for MI. CASE PRESENTATION AND INTERVENTION: A morbidly obese 17-year-old male, a nonsmoker, nondiabetic and normotensive patient, who sustained acute inferior MI with no family history of coronary artery disease, presented with central chest pain. ECG showed low voltage, normal sinus rhythm and ST segment elevation in the inferior leads; cardiac enzymes were elevated. Screening for ethanol and cocaine were negative. He was admitted to the coronary-care unit as a case of inferior MI with late presentation. cardiac catheterization revealed patent epicardial coronary arteries; short- and long-term plans for weight reduction and family counseling were started. The hospital stay was uneventful, and the patient was discharged home on the fourth day. CONCLUSION: Based on clinical and laboratory findings, we assume that the MI might partly be secondary to coronary artery spasm or invisible premature atherosclerotic plaques. Public education and awareness for this complication in a young obese patient are warranted.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
7/15. Self-healing pseudoangiosarcoma. Unusual vascular proliferation resembling a vascular malignancy of the skin.Pseudomalignant vascular lesions are increasingly recognized by dermatologists and may be present in several disorders affecting vessels. We describe a 58-year-old obese woman who developed vascular papulonodular lesions in the left inguinocrural area, clinically and histologically resembling a malignant vascular proliferation, that spontaneously regressed within a few months, after bed rest and weight reduction. Therefore, our patient's vascular lesions appear to have been pseudomalignancies. There are no other similar conditions reported in the literature. This kind of disorder demonstrates that vascular tissue can be involved in very bizarre cell and tissue reactions to several stimuli and can mimic malignant neoplasms. We stress the importance of constant surveillance of this kind of lesion to collect adequate clinical data, because histologic findings alone may cause misdiagnosis and lead to treatment hazardous to the patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/15. zygomycosis caused by Apophysomyces elegans.A case of zygomycosis caused by Apophysomyces elegans in a diabetic, obese female is described. The fungus gained entry into the body through injury to the skin, penetrating the keratin, epidermis, and dermis. Hyphal angioinvasion was observed. Fungal elements invaded the subcutaneous fat, skeletal muscle fibers, nerves, and large blood vessels, resulting in the spread of the infection. The rapidity with which A. elegans invaded the blood vessels left no choice except amputation of the leg to stop the spread of the infection. This zygomycetous fungus closely resembles absidia corymbifera. It is distinguished by its prominent campanulate apophyses. In its gross colony characteristics and failure to sporulate on routinely used media it resembles Saksenaea vasiformis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/15. Bowel bypass arthritis dermatitis syndrome: a histological and electron microscopical study.A case of dermal vasculitis with arthralgia after intestinal bypass surgery is reported. A 36-year-old woman developed arthralgia and skin rash, 1 year after an ileo-jejunal bypass operation was performed for overweight (130 kg). skin biopsy showed leucocytoclastic vasculitis in the dermis. E.M. study showed clumps of platelets around small dermis blood vessels, and polymorphous perivascular infiltration. The symptoms subsided after tetracycline treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/15. Failure of intravenous regional analgesia using a double cuff tourniquet.A case is presented of an elderly, obese patient with calcified peripheral vessels in whom an intravenous regional analgesic technique failed because arterial occlusion could not be achieved safely with a double cuff tourniquet. The possible causes and precautions are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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