scholarly journals Computed tomography lymphangiography via intrametatarsal pad injection is feasible in cats with chylothorax

2022 ◽  
pp. 1-7
Author(s):  
Chuan Chiang ◽  
Kuan-Sheng Chen ◽  
Hsien-Chieh Chiu ◽  
Cheng-Shu Chung ◽  
Lee-Shuan Lin
Keyword(s):  
Contrast Medium ◽  
Medical Records ◽  
Surgical Planning ◽  
Lymphatic Vessels ◽  
Clinical Findings ◽  
Safe Procedure ◽  
Imaging Data ◽  
Cisterna Chyli ◽  
The Right

Abstract OBJECTIVE To evaluate the feasibility of CT lymphangiography via intrametatarsal pad injection in cats with chylothorax. ANIMALS 7 client-owned cats. PROCEDURES This was a multicenter, retrospective, descriptive study. Medical records and imaging data from 4 veterinary hospitals were reviewed to identify cats with chylothorax that had undergone intrametatarsal pad injection via CT lymphangiography. In total, 7 client-owned cats were included in the study. Signalment, history, image findings, and follow-up data were recorded. Descriptive statistics were used to analyze the success rate of thoracic duct (TD) enhancement and describe relevant clinical findings. RESULTS Enhancement of TDs was successful in 6 of the 7 cats within 5 to 15 minutes after initiating intrametatarsal pad injection under general anesthesia. Successful migration of contrast medium into the lymphatic vessels cranial to the popliteal lymph nodes was observed in all cats within 5 minutes after injection. The recommended dose of contrast medium to achieve TD enhancement was 1 mL/kg (0.5 mL/kg/pad; concentration, 350 mg of iodine/kg). Only 1 cat had mild swelling of the paws after the procedure, and it recovered quickly without pain medication; no cats experienced lameness. Similar to dogs and unlike in previously published reports, 72% of TD branches were located in the right hemithorax. CLINICAL RELEVANCE CT lymphangiography via intrametatarsal pad injection is a feasible and safe procedure for cats with chylothorax. This technique provides detailed information regarding the unique TD anatomy and cisterna chyli location. It also contributes to surgical planning.

Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz
Keyword(s):  
Intraocular Pressure ◽  
Female Patient ◽  
Congenital Glaucoma ◽  
Safe Procedure ◽  
Primary Congenital Glaucoma ◽  
History Of ◽  
Kahook Dual Blade ◽  
The Right ◽  
Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

A thrombosing, giant, distal posterior cerebral artery aneurysm in a newborn infant

2012 ◽  
Vol 10 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Pulat Akın Sabanci ◽  
Yavuz Aras ◽  
Aydın Aydoseli ◽  
Serra Sencer ◽  
Altay Sencer ◽  
...  
Keyword(s):  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Male Infant ◽  
Clinical Findings ◽  
Imaging Data ◽  
Therapeutic Decision Making ◽  
Cerebral Artery Aneurysm ◽  
Rare Situation ◽  
Neuroradiological Imaging

Intracranial aneurysms are extremely rare in infancy. No consensus has yet been developed about the exact treatment of this rare situation. The authors report the case of a 47-day-old male infant who had multiple seizures on the same day, leading to the diagnosis of an intracranial aneurysm. The case was managed conservatively with close imaging follow-up, and the patient had a good recovery. The results of neurological examination were completely normal at the 5-year follow-up visit. These rare lesions may be suspected on the basis of clinical findings and correctly diagnosed with current neuroradiological imaging modalities. The authors believe this report contributes valuable imaging data on rare childhood aneurysms to the literature, as well as emphasizing the importance of clinical and imaging information in therapeutic decision making in children with intracranial vascular problems.

scholarly journals Case Series on Perforator Aneurysm: Endovascular Stenting—A Safe Strategy

2017 ◽  
Vol 01 (03) ◽  
pp. 179-183 ◽  
Author(s):  
Chandra Sahu ◽  
Ashish Ashpilaya
Keyword(s):  
Case Series ◽  
Treated Group ◽  
Vascular Lesions ◽  
World Federation ◽  
Imaging Data ◽  
Anterior Circulation ◽  
Fisher Grade ◽  
Complete Thrombosis ◽  
The Right

AbstractPerforator aneurysms are rare vascular lesions that are infrequently reported in literature, and because of difficult anatomic approach, their treatment and management pose challenges. Given the rarity of these aneurysms, the natural history and ideal approach to treatment has not been established. The authors retrospectively analyzed six patients, age ranging from 16 to 75 years with ruptured perforator aneurysm, four of posterior circulation and two of anterior circulation including clinical characteristics, imaging data, treatment regimen, and outcome. All but two patients presented with the World Federation of Neurosurgical Societies grades I to III and Fisher grade 2 or 3 subarachnoid hemorrhage, and the other two presented with intracerebral bleed in the right gangliocapsular region. Four patients were managed conservatively whereas two basilar perforator aneurysms were treated with endovascular stent. At the last follow-up, the endovascularly treated group of patients demonstrated complete thrombosis of aneurysm with preservation of perforators, and the conservatively managed group showed spontaneous occlusion in one patient, whereas three were lost to follow-up and ultimate outcome remains unknown. The authors report single-center hospital-based experience in six patients, which adds to the scarce published literature that addresses the limited understanding of the natural course and consolidating safe endovascular management of this entity.

scholarly journals Clinical Characteristics of Intermittent Esotropia

2021 ◽  
Vol 62 (12) ◽  
pp. 1650-1656
Author(s):  
Young Chae Yoon ◽  
Nam Yeo Kang
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Clinical Findings ◽  
Main Symptom ◽  
Angle Of Deviation ◽  
The Mean ◽  
Onset Angle ◽  
Dissociated Vertical Deviation

Purpose: To evaluate clinical findings and surgical outcomes of intermittent esotropia.Methods: We retrospectively reviewed the medical records of 23 patients (aged 9-42 years) who presented with intermittent esotropia between January 2007 and December 2020. We analyzed the age at onset, angle of deviation, presence of symptomatic diplopia, fusional state, near stereoacuity, and surgical results.Results: The mean age at onset was 19.9 ± 8.0 years and mean duration of esodeviation was 23.4 ± 27.1 months. Mean follow-up time was 13.0 ± 15.6 months. All patients except three had symptomatic diplopia, and 78.3% showed intermittent diplopia. Mean angles of deviation were 21.6 ± 10.3 prism diopters (PD) at distance and 20.2 ± 10.4 PD at near. Twenty-one patients (91.3%) were myopia. No patients had amblyopia and one had dissociated vertical deviation. On Worth’s four-dot test, five patients (21.7%) showed diplopia and four showed suppression at both distance and near. The other patients showed fusion at near or distance. Eleven patients underwent surgical correction. At the final examination, all patients achieved successful motor alignment and fusion with resolution of diplopia. Only two patients (18.2%) achieved normal 60 arcsec stereopsis, and six attained subnormal stereopsis.Conclusions: The main symptom of intermittent esotropia was diplopia. Surgical treatment was effective in achieving good postoperative motor alignment and fusion. However, successful motor alignment did not guarantee recovery of fine stereopsis.

scholarly journals Using aneurysm clips for repair of cisterna chyli injury during posterior spinal fusion

2021 ◽  
Vol 12 ◽  
pp. 428
Author(s):  
Robert McCabe ◽  
Doris Tong ◽  
Connor Hanson ◽  
Dejan Slavnic ◽  
Teck Mun Soo
Keyword(s):  
Surgical Complication ◽  
Lymphatic Vessels ◽  
Posterior Spinal Fusion ◽  
Cord Compression ◽  
Anterior Longitudinal Ligament ◽  
Interbody Cage ◽  
Pelvic Fixation ◽  
Cisterna Chyli

Background: Injury to the cisterna chyli (CC) is a rare surgical complication with a lack of literature describing its repair. Aneurysm clips have been successfully used to repair durotomies. Its usage in lymphatic injury has never been described. We sought to demonstrate the use of aneurysm clips for the repair of lymphatic vessels. Case Description: A 60-year-old male retired physician with Parkinson’s disease underwent a lumbosacral instrumented fusion with pelvic fixation (L1-pelvis) in 2011. He returned 5 months postoperatively after a fall and was ambulatory with a cane upon admission. CT demonstrated worsening kyphosis with pedicular and superior endplate fracture at the fusion apex. MRI revealed spinal cord compression at the failed level. Extension thoracolumbar fusion was performed (T3-L1) with intraoperative violation of the anterior longitudinal ligament (ALL) during T12/L1 discectomy. CC laceration was suspected. The ALL was dissected from the CC and aorta, allowing visualization of the injury. Three curved aneurysm clips were applied to the lacerated CC, which was visually inspected to ensure a patent lumen. The disk space was filled with poly-methyl-methacrylate cement in place of an interbody cage, preventing migration of the clips. The patient underwent rehabilitation in an inpatient facility with improved ambulation. He has had regular clinic follow-up and was last seen in 2020 with no evidence of lymphedema noted. Conclusion: CC injury is rare, and usage of aneurysm clips in its repair has never been described. We demonstrate the safe use of aneurysm clips to repair CC injury with long-term favorable clinical outcomes.

scholarly journals Clinical and Paraclinical Features of Wilson’s Disease in Children in Shiraz, Southern Iran

2014 ◽  
Vol 3 (3) ◽  
pp. 160-66
Author(s):  
Seyed Mohsen Dehghani ◽  
Asma Erjaee ◽  
Mohammad Hadi Imanieh ◽  
Mahmood Haghighat ◽  
Zohre Bajalli ◽  
...  
Keyword(s):  
Medical Records ◽  
Autosomal Recessive ◽  
Clinical Findings ◽  
Medical Sciences ◽  
Progressive Degeneration ◽  
Urinary Copper ◽  
The Mean ◽  
High Index Of Suspicion ◽  
Biochemical Abnormalities

Background: Wilson disease (WD) is an autosomal recessive progressive degeneration of hepatolenticular tissue that causes the increase of copper deposition in the liver and other organs, with resultant hepatic, neurologic and psychological manifestations. WD is fatal if left untreated. The aim of the current study was to evaluate the clinical and Para-clinical findings in children with WD in Shiraz, Southern Iran.Patients and Methods: The Medical records of all children less than 18 years of age with definite diagnosis of WD, who were admitted in Nemazee Teaching Hospital from 2001 to 2009, or were under follow up at the Pediatric Hepatology Clinic affiliated to Shiraz University of Medical Sciences, were reviewed.Results: Overall, 70 patients with WD (41 males, 29 females) were studied. The mean age at the onset of diagnosis was 10.3±3.2 years and the most common first presentation in our patients was hepatic (90%). The most common biochemical abnormalities were increased urinary copper content, increased liver enzymes (92.9%), and increased prothrombin time (71.4%). Wilson index was ≥11 in 44.3% of the patients.Conclusion: WD is a rare and fascinating disorder that often poses a diagnostic and therapeutic challenge for the physician. Maintaining a high index of suspicion is critical in diagnosing this readily treatable disease and early treatment can decrease its mortality rate.

Abstract TP59: Atherosclerosis and Unsuccessful Recanalization in Acute Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Cynthia Zevallos ◽  
Kiddy Ume ◽  
Matthew Weber ◽  
Abigail Levy ◽  
Andrea Holcombe ◽  
...  
Keyword(s):  
Medical Records ◽  
Regression Models ◽  
Imaging Data ◽  
Inpatient Mortality ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Logistic Regression Models ◽  
Noncontrast Ct ◽  
Clot Burden

Unsuccessful recanalization rates in acute ischemic stroke patients range between 8-18%. Currently, there are no models to predict thrombectomy reperfusion success with current thrombectomy techniques. We aimed to describe the clinical and radiological features of patients with unsuccessful thrombectomy (UT) and its association with intracranial atherosclerosis (ICAD). A cohort of 413 consecutive, adult, thrombectomy patients admitted to two comprehensive stroke centers were reviewed from 2014 to 2017. Patients with anterior circulation large vessel occlusions (LVOs) and a thrombolysis in cerebral infarction (TICI) score of ≤2a were selected. Demographics, clinical and imaging data were obtained from electronic medical records. Head CT, CT angiography and digital subtraction angiography (DSA) images were reviewed by one independent investigator to evaluate ASPECTS score, vessel calcifications, clot burden score and CTA and DSA collateral score. Proposed causes of UT were categorized based on angiography evaluation by two independent neurointerventionalists. Analysis was performed using descriptive frequency analysis and univariate logistic regression models. A total of 87 low TICI score (≤2a) patients from 413 procedures were included. The median age was 74 years (IQR 58.5-84) and 58% were female. The most common comorbidity was hypertension (73.5%), followed by hyperlipidemia (46%). TICI score of 0 was found in 23% (N=20), 1 in 9.2% (N=8), and 2a in 67.8% (N=59). The inpatient mortality rate was 19.5% (17/87). Out of the remaining 70 patients, 78.5% (N=55) had a 3-month follow up modified Rankin Scale (mRS) of 3-6. The most common proposed cause of poor revascularization in our study was presence of ICAD [29.9% (n=32) of patients]. In our cohort of UT patients with ICAD, 68.8% (N=22) had TICI 2a score with majority (96.8%) having a 3 months mRS of 3-6. Patients with ICAD had 7.3% increased odds of having angiographic collateral score of 5 (p=0.035) and 15.2% increased odds of having an absence of hyperdense MCA in noncontrast CT scan (p=0.003). ICAD is frequently found in patients that undergo UT. Identification of radiological predictors of ICAD may be helpful to consider alternative revascularization strategies for LVOs.

scholarly journals Cervical disc prosthesis: 2-year follow-up

2015 ◽  
Vol 14 (2) ◽  
pp. 85-87
Author(s):  
Romero Pinto de Oliveira Bilhar ◽  
Alexandre Fogaça Cristante ◽  
Raphael Martus Marcon ◽  
Ivan Dias da Rocha ◽  
Olavo Biraghi Letaif ◽  
...  
Keyword(s):  
Medical Records ◽  
Epidemiological Data ◽  
Cervical Disc ◽  
Safe Procedure ◽  
Disc Prosthesis ◽  
Cervical Arthroplasty ◽  
Cervical Disc Prosthesis ◽  
The Mean

<sec><title>OBJECTIVE:</title><p> To review the medical records of patients who underwent surgery for placement of cervical disc prosthesis after two years of postoperative follow-up, showing the basic epidemiological data, the technical aspects and the incidence of complications.</p></sec><sec><title>METHODS:</title><p> Medical records of seven patients who underwent surgery for placement of cervical disc prosthesis were reviewed after two years of follow-up, at the Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo.</p></sec><sec><title>RESULTS:</title><p> The average age of patients participating in this study was 43.86 years. Six patients (85.7%) had one level approached while one patient (14.3%) had two levels addressed. The level C5-C6 has been approached in one patient (14.3%) while the C6-C7 level was addressed in five patients (71.4%). One patient (14.3%) had these two levels being addressed, C5-C6 and C6-C7. The mean operative time was 164.29±40 minutes. Three patients were hospitalized for 2 days and four for 3 days making an average of 2.57±0.535 days. Two patients (28.6%) underwent a new surgical intervention due to loosening of the prosthesis. The mean follow-up was 28.14±5.178 months (23-35 months).</p></sec><sec><title>CONCLUSIONS:</title><p> Although cervical arthroplasty appears to be a safe procedure and present promising results in our study as well as in many other studies, it requires long-term studies.</p></sec>

PTEN hamartoma tumour syndrome: early tumour development in children

2014 ◽  
Vol 100 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Patroula Smpokou ◽  
Victor L Fox ◽  
Wen-Hann Tan
Keyword(s):  
Renal Cell Carcinoma ◽  
Medical Records ◽  
Thyroid Nodules ◽  
Clinical Manifestations ◽  
Clinical Findings ◽  
Granulosa Cell Tumour ◽  
Tumour Development ◽  
Age Of Diagnosis ◽  
The Mean

ObjectiveThe aim of this study was to report the earliest age of diagnosis of common clinical findings in children with PTEN hamartoma tumour syndrome (PHTS).DesignMedical records of children with PHTS were reviewed; data included growth measurements, presence or absence of specific clinical manifestations and tumours, and documented ages of diagnosis.SettingChildren with PHTS evaluated at Boston Children's Hospital from 1996 to 2011.PatientsThe cohort included 34 children diagnosed with PHTS via genetic testing, under the age of 21 years. Of these, 23 were male and 11 female. The mean age at their last documented clinical evaluation was 13.6 years. The mean follow-up time was 7.5 years.ResultsMacrocephaly and developmental/intellectual disability were consistent findings. Pigmented penile macules were noted in all males examined for this finding. Thyroid nodules, found in half the children screened with ultrasound, were diagnosed as early as at 5 years of age. Thyroid carcinoma, identified in 12% of the children in this cohort, was diagnosed as early as at 7 years of age. Other tumours included renal cell carcinoma diagnosed at 11 years of age and granulosa cell tumour of the ovary and colonic ganglioneuroma, each diagnosed at 16 years of age.ConclusionsSpecific clinical findings and tumours are characteristic in children with PHTS. Tumour development occurs in young children with this condition, which necessitates early surveillance, especially of the thyroid.

Feline ophthalmomyiasis externa caused by Cuterebra larvae: four cases (2005–2020)

2021 ◽  
pp. 1098612X2110130
Author(s):  
Brittany N Schlesener ◽  
Elizabeth A Peck ◽  
Eric M Teplitz ◽  
Filipe Espinheira Gomes ◽  
Dwight D Bowman ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Signs ◽  
Case Series ◽  
University Hospital ◽  
Nictitating Membrane ◽  
Cornell University ◽  
Unilateral Disease ◽  
The Right ◽  
Lost To Follow Up

Case series summary Described are four cats diagnosed with ophthalmomyiasis externa caused by Cuterebra larvae. Medical records were retrospectively reviewed to identify cats with ophthalmomyiasis externa between 2005 and 2020 at Cornell University Hospital for Animals. Signalment, history, clinical and diagnostic findings, treatment and outcome were recorded. All cats were young (< 3 years of age), had outdoor access and were initially examined during the summer months. All cases had unilateral disease with the right eye affected. Two cases had nictitating membrane lesions and two had orbital disease. Concurrent superficial corneal ulceration was present in three cats. Two cats suffered from pyrexia, suspected secondary to inflammation from the larval infestation. Successful larval removal was performed in all cats, which resulted in improvement of discomfort and clinical signs. A corneal ulcer persisted in one cat, which was lost to follow-up prior to ulcer resolution. Parasite identification confirmed Cuterebra species infestation in all cases. Relevance and novel information To the authors’ knowledge, this is the first report of feline ophthalmomyiasis externa caused by Cuterebra species. Parasite removal was successful in restoring comfort and resolving clinical signs in all cats with adequate follow-up information.

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