RESUMEN
A radial artery free graft was used to create a two-coronary artery system for a 15-month-old child with Bland-White-Garland syndrome. The anomalous left main coronary artery originated from the proximal right pulmonary artery.
Asunto(s)
Puente de Arteria Coronaria/métodos , Anomalías de los Vasos Coronarios/cirugía , Arteria Pulmonar/anomalías , Arteria Radial/trasplante , Aortografía , Cateterismo Cardíaco , Anomalías de los Vasos Coronarios/diagnóstico , Femenino , Humanos , Lactante , SíndromeRESUMEN
Color-flow Doppler ultrasound was used to assess the anatomic characteristics of the inferior epigastric artery (IEA) bilaterally in 20 nonatherosclerotic (group I; mean age, 28 years) and 20 atherosclerotic (group II; mean age, 57 years) subjects. Forty-nine percent of the IEAs were located laterally within the rectus sheath with 34% in a mid and 17% in a medial location. Seventeen percent had a large branch within 5 cm of the origin. Average length of the IEA was 10.7 +/- 3.2 cm. Average proximal and distal internal diameters were 3.0 +/- 0.45 and 1.9 +/- 0.35 mm, respectively. Neither length nor vessel diameter showed any correlation with age or body surface area. Sixty-two percent of the IEAs were greater than or equal to 9 cm in length and 1.5 mm in distal diameter. Stenosis of the vessel (more than 50% diameter) was noted at the proximal 1 cm segment in 20% of the IEAs in the atherosclerotic group but none of the IEAs in the nonatherosclerotic group. Beyond this proximal segment, there was freedom from atherosclerotic stenosis as demonstrated by the IEAs' similarity of length and diameter irrespective of age in these atherosclerotic and nonatherosclerotic populations.
Asunto(s)
Músculos Abdominales/irrigación sanguínea , Arteriosclerosis/diagnóstico por imagen , Arteriosclerosis/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Arterias/diagnóstico por imagen , Arterias/trasplante , Arteriosclerosis/epidemiología , Superficie Corporal , Estudios de Evaluación como Asunto , Humanos , Persona de Mediana Edad , Revascularización Miocárdica/métodos , Factores de Riesgo , Ultrasonografía , Grado de Desobstrucción VascularRESUMEN
A 6-week-old male infant with a capillary hemangioma of the right atrioventricular groove adjacent to the right coronary artery and conduction system underwent successful resection with the aid of microneurosurgical instrumentation. The technical challenge was thought to be analogous to that encountered by microneurosurgeons in their dissection of brain tumors.
Asunto(s)
Neoplasias Cardíacas/cirugía , Hemangioma Capilar/cirugía , Humanos , Lactante , Masculino , Microcirugia/instrumentación , Microcirugia/métodos , Neurocirugia/instrumentación , Neurocirugia/métodosRESUMEN
Isolation of the left carotid artery is extremely rare. We report a case of isolation of the left carotid artery with CHARGE association. Aortic arch abnormalities should be looked for in all children with CHARGE association. The technique of repair involved implantation of the isolated left carotid artery to the ascending aorta.
Asunto(s)
Arterias Carótidas/anomalías , Cardiopatías Congénitas , Anastomosis Quirúrgica , Aorta/cirugía , Arterias Carótidas/cirugía , Atresia de las Coanas , Coloboma , Oído Externo/anomalías , Femenino , Trastornos del Crecimiento , Cardiopatías Congénitas/cirugía , Humanos , Recién Nacido , Discapacidad Intelectual , SíndromeAsunto(s)
Cilios/ultraestructura , Nasofaringe/ultraestructura , Infecciones del Sistema Respiratorio/patología , Adolescente , Adulto , Preescolar , Cilios/enzimología , Dineínas/análisis , Humanos , Masculino , Microscopía Electrónica , Microtúbulos/ultraestructura , Oligospermia , Situs Inversus/patología , SíndromeRESUMEN
The clinical course of five infants with heptic hemangioendothelioma is reviewed. Hemodynamic abnormalities observed at cardiac catheterization included an increased cardiac output (range, 9.2 to 10.5 liters/min/sq m) with over 50% of this output being shunted through the arteriovenous malformation, an elevated right and left end diastolic pressure (8 to 10 mm Hg and 9 to 15 mm Hg respectively), a small systolic pressure gradient across the pulmonary outflow tract (4 to 6 mm Hg), and mild elevation of pulmonary artery pressure (range, 35/16 to 37/12 mm Hg). All four patients treated with prednisone improved while on therapy; three are well one to three years after cessation of therapy. One patient died from unrecognized congestive heart failure following discontinuation of prednisone and another before prednisone was started. We conclude that prednisone in high doses (2 to 4 mg/kg/day) with the addition of digitalis and diuretics for control of congestive heart failure is an effective treatment regimen for infants with hepatic hemangioendothelioma.
Asunto(s)
Hemangioendotelioma/fisiopatología , Hemodinámica , Neoplasias Hepáticas/fisiopatología , Presión Sanguínea , Cateterismo Cardíaco , Gasto Cardíaco , Femenino , Hemangioendotelioma/sangre , Hemangioendotelioma/tratamiento farmacológico , Humanos , Lactante , Recién Nacido , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/tratamiento farmacológico , Masculino , Oxígeno/sangre , Prednisona/uso terapéutico , Circulación PulmonarRESUMEN
Although the population lives in a higher latitude, the incidence of and death rate from skin cancer is approximately the same in Sweden as it is in England and Wales. The proportion of malignant melanoma is higher in the Swedish deaths and the death rate from malignant melanoma is higher in Sweden than in England and Wales.The ratios of male to female cases and deaths from malignant melanoma are higher in Sweden than in England and Wales.These differences do not appear likely to be due to differences in the statistical or medical care systems, and suggest important genetic and occupational effects.Total skin cancer rates and rates summarizing all ages may be poor indicators of the real variations between populations in the epidemiology of malignant skin tumours.