Optic Nerve Pilocytic Astrocytoma With Leptomeningeal Dissemination – Case Report

2021 ◽  
Vol 14 (63) (1) ◽  
pp. 37-42
Author(s):  
Claudia Raluca Mărginean ◽  
Patricia Maria Luminița Simu ◽  
Robert Aurelian Tiucă ◽  
Alexandru Mariean-Șchiopu ◽  
Iunius Paul Simu
Keyword(s):  
Optic Nerve ◽  
Pilocytic Astrocytoma ◽  
Tumor Location ◽  
Good Prognosis ◽  
Incomplete Resection ◽  
Leptomeningeal Dissemination ◽  
Term Survival ◽  
Long Term Follow Up ◽  
The Right

"Pilocytic astrocytoma is the most frequent type of brain tumor diagnosed during childhood. It originates from midline structures and is associated with good prognosis, with an estimated survival rate higher than 95%. We presented the case of a male patient diagnosed at the age of 6 with pilocytic astrocytoma located in the right optic nerve with associated chiasm infiltration. Incomplete resection of the tumoral process was performed, without any additional therapy, as association of chemotherapy or radiotherapy is still controversial among specialists. The patient had an unpredictable severe evolution of the disease, with associated leptomeningeal dissemination and extreme worsening of neurological and endocrinologic status. Six years after diagnosis, despite complex medical efforts the patient died. This article raises awareness of leptomeningeal dissemination risk, a rare evolution in cases of pilocytic astrocytoma. Early diagnosis, complete tumoral resection, tumor location and careful long-term follow up are key factors for long-term survival. "

Physiological Pacing: A New Road to Future

2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri
Keyword(s):  
Side Effects ◽  
Fibrous Tissue ◽  
Cardiac Pacing ◽  
His Bundle ◽  
Anatomy And Physiology ◽  
Long Term Follow Up ◽  
Pacing Lead ◽  
The Right

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.

scholarly journals Long term follow-up of inguinal endometriosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
BoRan Mu ◽  
ZhiQiang Zhang ◽  
Chongdong Liu ◽  
Kunning Zhang ◽  
ShuHong Li ◽  
...  
Keyword(s):  
Management Strategies ◽  
Uterosacral Ligament ◽  
Round Ligament ◽  
Pelvic Endometriosis ◽  
Ovarian Endometriosis ◽  
Hernia Sac ◽  
Peritoneal Endometriosis ◽  
Long Term Follow Up ◽  
The Right

Abstract Background Inguinal endometriosis (IEM) is a rare extra pelvic endometriosis. Here, we study the clinical characteristics, management strategies, and long-term gynecological outcomes of IEM patients at Beijing Chaoyang Hospital. Case presentation Three patients presented with a total of four lesions (one on the left side, one on the right side, and one bilaterally). The diameters of the four lesions were 2 cm, 2 cm, 3.5 cm and 1.5 cm, respectively. Two patients were admitted with inguinal hernias. Two patients were admitted with endometrioses—one with ovarian endometriosis and one with pelvic endometriosis. The hernia sac was repaired concomitantly via excision of the round ligament in two patients. One patient underwent a concomitant laparoscopy for gynecologic evaluations, including an ablation to the peritoneal endometriosis, and resection of the left uterosacral ligament endometriosis and pelvic adhesiolysis. All lesions were located on the extraperitoneal portion of the round ligament and were diagnosed histologically. No recurrence was observed in the inguinal region. All patients diagnosed with adenomyosis were treated with medication alone without any complaints. Conclusions Inguinal endometriosis can occur simultaneously with pelvic endometriosis. In most cases, a concomitant hernia sac appears together with groin endometriosis. Clinical management should be individualized and performed in tandem with general practitioners and obstetrics & gynecology experts. Pelvic disease, in particular, should be followed-up by a gynecologist.

Transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder

2002 ◽  
Vol 12 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Haifa Abdul Latiff ◽  
Mazeni Alwi ◽  
Hasri Samion ◽  
Geetha Kandhavel
Keyword(s):  
Transcatheter Closure ◽  
Standard Procedure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Term Outcome ◽  
Long Term Follow Up ◽  
One Year ◽  
The Right

This study reviewed the short-term outcome of transcatheter closure of the defects within the oval fossa using an Amplatzer® Septal Occluder. From January 1997 to December 2000, 210 patients with defects within the oval fossa underwent successful transcatheter closure. We reviewed a total of 190 patients with left-to-right shunts, assessing the patients for possible complications and the presence of residual shunts using transthoracic echocardiogram at 24 h, 1 month, 3 months and one year. Their median age was 10 years, with a range from 2 to 64 years, and their median weight was 23.9 kg, with a range from 8.9 to 79 kg. In 5 patients, a patent arterial duct was closed, and in 2 pulmonary balloon valvoplasty performed, at the same sitting. The median size of the Amplatzer® device used was 20 mm, with a range from 9 to 36 mm. The median times for the procedure and fluoroscopy were 95 min, with a range from 30 to 210 min, and 18.4 min, with a range from 5 to 144 min, respectively. Mean follow-up was 20.8 ± 12.4 months. Complete occlusion was obtained in 168 of 190 (88%) patients at 24 h, 128 of 133 (96.2%) at 3 months, and 103 of 104 (99%) at one year. Complications occurred in 4 (2.1%) patients. In one, the device became detached, in the second the device embolized into the right ventricular outflow tract, the lower end of the device straddled in the third, and the final patient had significant bleeding from the site of venupuncture. There were no major complications noted on follow-up. We conclude that transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder is safe and effective. Long-term follow-up is required, nonetheless, before it is recommended as a standard procedure.

scholarly journals Advances in the management of craniopharyngioma in children and adults

2019 ◽  
Vol 53 (4) ◽  
pp. 388-396 ◽  
Author(s):  
Mojca Jensterle ◽  
Soncka Jazbinsek ◽  
Roman Bosnjak ◽  
Mara Popovic ◽  
Lorna Zadravec Zaletel ◽  
...  
Keyword(s):  
Survival Rates ◽  
Tumor Location ◽  
Subtotal Resection ◽  
Metabolic Complications ◽  
Optimal Outcomes ◽  
Parasellar Region ◽  
Long Term Follow Up ◽  
Considerable Controversy

Abstract Background Childhood and adult-onset craniopharyngioma is a rare embryogenic tumor of the sellar, suprasellar, and parasellar region. Survival rates are high; however, tumor location and treatment sequalae including endocrine deficits, visual impairment, metabolic complications, cognitive and psychosocial deficits can significantly impair patient’s quality of life. There is considerable controversy regarding the optimal management of craniopharyngiomas. Subtotal resection of the tumor followed by targeted irradiation to avoid further hypothalamic damage is currently indicated. Novel insights in the tumor’s molecular pathology present the possibility for targeted therapy possibly decreasing the rate and severity of treatment-associated morbidity. Conclusions Craniopharyngioma should be seen as a chronic disease. To achieve optimal outcomes a multidisciplinary team of specialized neurosurgeons, neuro-radiologists, neuro-oncologists, pathologists and endocrinologists should be involved in the diagnosis, planning of the surgery, irradiation and long-term follow-up.

Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

2020 ◽  
Vol 30 (3) ◽  
pp. 409-412
Author(s):  
Murat Surucu ◽  
İlkay Erdoğan ◽  
Birgül Varan ◽  
Murat Özkan ◽  
N. Kürşad Tokel ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Systolic Pressure ◽  
Presenting Symptoms ◽  
Long Term Follow Up ◽  
The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

scholarly journals A right coronary artery aneurysm 16 years after surgical repair of anomalous origin of the right coronary artery from the pulmonary artery

2019 ◽  
Vol 29 (1) ◽  
pp. 157-158
Author(s):  
Akira Furutachi ◽  
Kojiro Furukawa ◽  
Aiko Komatsu ◽  
Eijiro Nogami
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Coronary Artery ◽  
Surgical Repair ◽  
Artery Aneurysm ◽  
Anomalous Origin ◽  
Artery Graft ◽  
Long Term Follow Up ◽  
The Right

Abstract Anomalous origin of the right coronary artery (RCA) from the pulmonary artery is a very rare congenital heart disease, and several reports have described long-term events after surgery. We report the case of a 46-year-old woman who underwent reimplantation of the RCA for anomalous origin of the right coronary artery from the pulmonary artery 16 years ago. An RCA aneurysm gradually developed and dilated over time, and we resected the aneurysm and also grafted the right gastroepiploic artery graft to the distal RCA. Careful long-term follow-up is required to avoid overlooking such a rare but life-threatening complication after surgical repair of anomalous origin of the right coronary artery from the pulmonary artery.

Carcinoid of the Extra-Hepatic Bile Duct: A Case Report with Long-Term Follow-up and Review of Literature

2008 ◽  
Vol 74 (1) ◽  
pp. 87-90 ◽  
Author(s):  
Niraj J. Gusani ◽  
J. Wallis Marsh ◽  
Michael A. Nalesnik ◽  
Mitchell E. Tublin ◽  
T. Clark Gamblin
Keyword(s):  
Bile Duct ◽  
Carcinoid Tumor ◽  
Extrahepatic Bile Duct ◽  
Strong Support ◽  
Complete Excision ◽  
Term Survival ◽  
Long Term Survival ◽  
Long Term Follow Up

Extrahepatic bile duct tumors, 80 per cent of which are adenocarcinomas, are rare neoplasms accounting for less than two per cent of all cancers. Carcinoid tumor of the extrahepatic bile ducts is a reportable lesion, with only approximately 50 cases described in the literature since 1959. We present a case of a primary extrahepatic bile duct carcinoid tumor resected for cure with the longest reported follow-up time (11 years) after surgery. We also summarize the existing literature with regard to this rare tumor. Our case lends strong support to the notion that extrahepatic biliary carcinoids are generally indolent lesions that, if aggressively resected, can result in excellent long-term survival. Complete excision with clear margins seems to provide the best chance of obtaining long-term survival and cure.

Delayed Cerebrovascular Complications of Intrathecal Colloidal Gold

Neurosurgery ◽  
2001 ◽  
Vol 49 (6) ◽  
pp. 1308-1312 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Leslie A. Sebring ◽  
Joseph P. Neglia ◽  
Ray Chu ◽  
Nancy D. Mattsen ◽  
...  
Keyword(s):  
Colloidal Gold ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
External Beam Radiotherapy ◽  
University Of Minnesota ◽  
Gold Therapy ◽  
Term Survival ◽  
Cerebrovascular Complications ◽  
Long Term Follow Up

ABSTRACT OBJECTIVE Therapy with intrathecal colloidal gold has been used in the past as an adjunct in the treatment of childhood neoplasms, including medulloblastoma and leukemia. We describe the long-term follow-up period of a series of patients treated with intrathecal colloidal gold and emphasize the high incidence of delayed cerebrovascular complications and their management. METHODS Between 1967 and 1970, 14 children with posterior fossa medulloblastoma underwent treatment at the University of Minnesota. Treatment consisted of surgical resection, external beam radiotherapy, and intrathecal colloidal gold. All patients underwent long-term follow-up periods. RESULTS Of the 14 original patients, 6 died within 2 years of treatment; all experienced persistent or recurrent disease. The eight surviving patients developed significant neurovascular complications 5 to 20 years after treatment. Three patients died as a result of aneurysmal subarachnoid hemorrhage, and five developed ischemic symptoms from severe vasculopathy that resembled moyamoya disease. CONCLUSION Although therapy with colloidal gold resulted in long-term survival in a number of cases of childhood medulloblastoma, our experience suggests that the severe cerebrovascular side effects fail to justify its use. The unique complications associated with colloidal gold therapy, as well as the management of these complications, are presented. We recommend routine screening of any long-term survivors to exclude the presence of an intracranial aneurysm and to document the possibility of moyamoya syndrome.

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