1/14. Chronological changes in cerebral air embolism that occurred during continuous drainage of infected lung bullae.We present a 43-year-old man with cerebral air embolism that occurred during continuous drainage of infected lung bullae. This complication is extremely rare, and may have been caused by the passage of air into the pulmonary venous circulation through a bronchovenous fistula and/or damaged pulmonary vessels. air densities were demonstrated along the right frontal gyri on a CT performed 1 h after the onset of embolism, then moved to the deep cortex after 2.5 h. Three days later, a cortical infarct accompanied with extensive white matter edema in the right frontal lobe was confirmed by MRI. These CT and MRI findings may indicate the passage of intravascular air from the superficial to the deep cortex and subsequent cerebral infarction.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/14. Arterial embolization to preoperatively manage pulmonary disease associated with inflammation.Preoperative arterial embolization is used in pulmonary disease to reduce intraoperative blood loss resulting from exposure of extensive adherent pleura due to repeated inflammation. Between January 1996 and February 2001, 5 patients underwent surgery with this procedure. Underlying diseases were 3 cases of aspergilloma and 1 each of chronic expanding hematoma and lung cancer. All embolization was permanent, involving coil insertion. Surgical treatment was successful in all 5 patients without mortality. Such preoperative management proved useful in reducing intraoperative blood loss in hypervascular collateral feeding vessels in the area of resection or decortication.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/14. Inflammatory sarcomatoid carcinoma: a case report and discussion of a malignant tumor with benign appearance.Inflammatory sarcomatoid carcinoma is an aggressive tumor with an unusually benign appearance. We report the case of a 65-year-old man with a history of inoperable poorly differentiated carcinoma of the right lung, for which he had received chemoradiotherapy. A new solitary mass was discovered 4 years later in the left lung on surveillance computed tomography. The patient underwent thoracotomy with a wedge biopsy on which frozen section was performed. The nodule was vaguely granulomatous and associated with a mixed inflammatory infiltrate and a deceptively bland spindle cell proliferation. Results of immunoperoxidase studies, however, showed that the nodule contained neoplastic cells with an epithelial phenotype that were invading the pulmonary vessels. These are features of the rare inflammatory sarcomatoid carcinoma. In contrast to sarcomatoid carcinomas, this case highlights the deceptively benign appearance of inflammatory sarcomatoid carcinoma. This leads us to concur with the recommendation to exercise caution when attempting the diagnosis of apparently benign lesions on intraoperative frozen section in patients with high clinical suspicion of malignancy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/14. Nosocomial pulmonary rhizopus diagnosed by bronchoalveolar lavage with cytology in a child with acute lymphoblastic leukemia.rhizopus species is an opportunistic fungus that is contracted by inhalation of aerosolized spores. early diagnosis is often difficult but is a necessity to prevent rapid progression of the infection that leads to blood vessel invasion by hyphae, causing fatal hemoptysis. A previous case report described the utility of cytologic examination of bronchoalveolar lavage (BAL) fluid in achieving a prompt diagnosis of rhizopus species in an adolescent patient with diabetic ketoacidosis. The author presents a case that further describes the benefit of performing BAL fluid cytology to help identify fungal morphology characteristics in order to reach an expeditious diagnosis of rhizopus species in a leukemia patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/14. Perforated ventricular aneurysm in a male suffering from pneumonia.In a 49-year-old male with fever, dyspnea, and chest pain, thoracic x-ray revealed pneumonia with enlarged heart silhouette. Antibiotics were successful, pneumonia healed and complaints disappeared. Yet, during the following 3 months, echocardiography showed mild persistent pericardial effusion while in ECG both sinus tachycardia and ST-T changes were found suggesting chronic pericarditis. magnetic resonance imaging, however, revealed an extensive posterobasal aneurysm with pericardial effusion substantiated by ventriculography. coronary angiography showed diffuse three-vessel disease. Surgery revealed aneurysm with distinct perforation of the left ventricle and pericardial thrombi, thus aneurysmectomy as well as bypass grafts were performed. One year postoperatively, magnetic resonance imaging confirmed the absence of aneurysm with only a small irreversible posterobasal perfusion defect remaining as shown by thallium scintigraphy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/14. Nocardiosis: report of 2 cases with review of literature in thailand.Two cases of nocardiosis with underlying SLE are presented. Both were female patients aged 19 and 34 years and had been treated with steroid and endoxan for some time. death from lesions in the respiratory tract and right kidney with growth of nocardia asteroides at autopsy was noted in the first case. The second patient exhibited fever with dyspnea and subsequent peripheral neuromuscular dysfunction. Disseminated nocardial abscesses in multiple organs including lungs, liver, spleen, lymph nodes and subcutaneous tissue were disclosed postmortem. Moreover, intravascular dissemination of the organisms had resulted in thrombosis of several blood vessels supplying the spinal cord resulting in widespread myelomalacia. Recent infarction of a few spinal nerve roots was also observed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/14. Scintiangiographic demonstration of parasitization of systemic blood supply by inflammatory lung disease.An unusual case in which a computed tomogram demonstrated abnormal, enlarged vessels in the right lower lobe of the lung and suggested an arteriovenous malformation is presented. A scintiangiogram showed abnormal systemic supply to this area in the aortic phase. Contrast angiography demonstrated hypertrophy of the right inferior phrenic artery with abnormal systemic supply to the pleura and parenchyma of the right lower lobe, presumably on the basis of old infection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/14. Bronchopleural fistula followed by massive fatal hemoptysis in a patient with pulmonary mucormycosis. A case report.A patient had complications of invasive pulmonary mucormycosis. A bronchopleural fistula developed, representing a rare complication of pulmonary mucormycosis. Massive fatal hemoptysis occurred, due to the propensity of mucormycosis to invade blood vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/14. Ischemic necrosis of both lower extremities as a result of the microembolism syndrome complicating the adult respiratory distress syndrome caused by escherichia coli pneumonia and septicemia.Extensive gangrene of both lower extremities necessitating bilateral above-the-knee amputations complicated the adult respiratory distress syndrome (ARDS) caused by escherichia coli pneumonia and septicemia in a 52-yr-old man. Concurrent with the evolution of tissue necrosis, peripheral blood leukocyte and platelet counts fell, and pulmonary vascular resistance increased. Adequacy of the cardiac output was confirmed by repeated thermodilution cardiac output measurements, and major vascular occlusion was excluded surgically. fibrin degradation products and thrombocytopenia were present, but the other usual criteria for disseminated intravascular coagulation were absent. Small vessel thrombosis by fibrin and leukocytes was observed histologically in the amputated extremities. These findings suggest that gangrene was due to the "microembolism syndrome"--diffuse small vessel occlusion by fibrin thrombi complicating ARDS. This unusual complication of ARDS may occur without abnormalities suggestive of diffuse intravascular coagulation in routine laboratory tests of blood coagulation. It should be suspected and treated promptly to avoid severe disability in survivors.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/14. paraplegia due to peripheral venous air embolus in a neonate: a case report.A term male infant with pneumonia was receiving fluid and antibiotics through an intravenous line in the scalp. air was accidentally infused in this line. Subsequently, discoloration of the skin, a flaccid paraplegia, hematuria, and gastrointestinal bleeding occurred as the presumed effect of venous air entering the systemic arteries. The umbilical vessels were never catheterized. Absence of any apparent cerebral air embolism is interpreted as being due to the infant's position (head down) at the time of air infusion. The pathogenesis and prevention of this tragic complication are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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