scholarly journals Complete agenesis of the right hemi-diaphragm in an adult: case report and literature review.

2021 ◽  
Vol 63 (3) ◽  
Author(s):  
Abdulsalam Yaseen Taha ◽  
Kalandar Kaznazani
Keyword(s):  
Mesh Repair ◽  
English Literature ◽  
Shortness Of Breath ◽  
Adult Case ◽  
Respiratory Compromise ◽  
Modest Improvement ◽  
Surgical Exploration ◽  
Serial Ct ◽  
Congenital Agenesis ◽  
The Right

Congenital agenesis of the hemi-diaphragm (AHD) in adults is rare and exceedingly so on the right side. Since its first recognition in 1959, no more than 9 cases have been published in the English literature by the year 2016. “Partial diaphragm agenesis” is actually large congenital diaphragmatic hernia (CDH) rather than true AHD. Respiratory compromise is the likely presentation, however, patients may survive for years without symptoms. Despite a straightforward clinical and radiographic diagnosis of AHD, the best method of repair is controversial. Herein, we present a case of complete right-sided AHD in a man of 54 diagnosed on surgical exploration 16 years earlier. Despite trans-thoracic mesh repair, the patient experienced just a modest improvement of his shortness of breath (SOB). Though the liver persisted high in the chest as shown by serial CT scans of the chest, polypropylene mesh was effective in preventing further visceral herniation. Adult patients with right-sided AHD always deserve operative intervention to avoid the potential complications.

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study

2015 ◽  
Vol 10 (4) ◽  
pp. 241-247
Author(s):  
Pieter W.J. Lozekoot ◽  
Sandro Gelsomino ◽  
Paul B. Kwant ◽  
Orlando Parise ◽  
Francesco Matteucci ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Lung Tissue ◽  
Lung Ventilation ◽  
Cardiothoracic Surgery ◽  
Respiratory Compromise ◽  
One Lung Ventilation ◽  
New Device ◽  
Lead Placement ◽  
The Right

Objective Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. Methods The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. Results Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. Conclusions The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

#3117 Fregoli syndrome in primary and secondary psychosis: a case level meta-analysis

2021 ◽  
Vol 92 (8) ◽  
pp. A18-A18
Author(s):  
Maria Teixeira-Dias ◽  
Amber Kaur Dadwal ◽  
Graham Blackman
Keyword(s):  
Right Hemisphere ◽  
English Literature ◽  
Meta Analysis ◽  
First Episode ◽  
Bias Assessment ◽  
Random Effects Models ◽  
Episode Psychosis ◽  
Treatment Responses ◽  
The Right

Objectives/AimsFregoli syndrome is a rare delusion characterised by the misidentification of an individual, typically of someone who the patient has an emotional link towards. The pathoaetiology of Fregoli syndrome remains largely a mystery, however, it has been described in patients experiencing either a primary or secondary (organic) psychosis. We sought to compare the neuropsychiatric features of Fregoli syndrome in primary and secondary psychosis.MethodsA patient-level meta-analysis was conducted. Five databases were searched for any descriptions of Fregoli syndrome. The patients and the psychotic episodes details alongside the co-occurring neuropsychiatric features and treatment responses were extracted. A risk of bias assessment was carried by scoring the methodological quality of all case studies. Random-effects models were used to pool the data and odds ratios and 95% confidence intervals were estimated for each of the neuropsychiatric features extracted between primary and secondary psychoses groups.ResultsA total of 119 patients (62 with primary psychosis, 50 with secondary psychosis and 7 with mixed or unknown aetiology) with Fregoli syndrome were identified in the English literature. Persecutory features were more likely to occur in patients with primary Fregoli syndrome (OR = 0.26, 95% CI[0.10;0.67], p < 0.01). In addition, Fregoli syndrome in the context of a first-episode psychosis (OR = 11.00, 95% CI [2.45;49.39], p < 0.01) and in the presence of neuroimaging abnormalities (OR = 20.19, 95% CI [4.36; 93.47], p < 0.01) was significantly associated with secondary aetiology. Patients in the secondary psychosis group (n=14) showed more right hemisphere lesions than patients in the primary psychosis group (n=1), however this trend was not significant (p = 0.10). Furthermore, no statistical differences between psychoses groups were found for the demographic, clinical and neurophysiological features analysed.ConclusionsThis is the first meta-analysis investigating the features of Fregoli syndrome in primary and secondary psychosis.Findings suggest that secondary causes of Fregoli syndrome are associated with a first-episode of psychosis and that neuroimaging abnormalities, particularly in the right hemisphere, are associated with a secondary organic cause.

Osteogenic Sarcoma of the Frontal Sinus

1973 ◽  
Vol 82 (2) ◽  
pp. 162-165 ◽  
Author(s):  
Robert C. Bone ◽  
Hugh F. Biller ◽  
Bernard L. Harris
Keyword(s):  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Frozen Section ◽  
English Literature ◽  
Osteogenic Sarcoma ◽  
Facial Bones ◽  
Plain Radiographs ◽  
History Of ◽  
Histologic Lesion ◽  
The Right

Although osteogenic sarcoma occurs in the head and neck, it is almost exclusively limited to the maxilla and the mandible. Single, rare cases of this tumor in other facial bones are mentioned in foreign reports, but a discussion in the English literature has not come to our attention. The case history of a 58-year-old woman with a nonspecific frontal sinus pain and right-sided proptosis is presented. Plain radiographs of the paranasal sinuses revealed a radiopaque, calcific mass in the right frontal sinus approximately 3 × 5 cm in diameter. It was noted that the mass had an “onionskin” lamination. Laminography aided in the exact localization of the mass; further, it was noted on arteriography that the frontal sinus mass did not invade the dura. A frozen section biopsy at the time of craniotomy suggested a benign histologic lesion. However, subsequent review of permanent sections showed findings typical of an osteogenic sarcoma. The patient was treated with irradiation and in the first postoperative year has done well.

scholarly journals Dry-air and long-term water (thermally indifferent) baths for the treatment of chronic nephritis

1907 ◽  
Vol 7 (11-12) ◽  
pp. 25-56
Author(s):  
R. Undrintsev
Keyword(s):  
Shortness Of Breath ◽  
Dry Air ◽  
Lower Back ◽  
Chronic Nephritis ◽  
The Face ◽  
The Right

Case IV. Patient M.K., 28 years old, a peasant. Was admitted to the clinic on September 15, 1906 with complaints of a strong cough with abundant discharge of either colorless, or dull yellow, or greenish sputum, severe shortness of breath, which allows the patient to sleep only on the right side, on prickly fingers legs and up to the lower back , when the legs cool down, on the swelling of the face, penis, scroti and legs. With movement, shortness of breath increases, and heartbeat begins.

Mitral Valve Surgery in a Patient with Dextrocardia and 180° Counter-clockwise Rotated Heart Due to Congenital Agenesis of the Right Lung

2013 ◽  
Vol 28 (6) ◽  
pp. 635-637
Author(s):  
Yosuke Atsumi ◽  
Shigehiko Tokunaga ◽  
Shota Yasuda ◽  
Kenichi Fushimi ◽  
Munetaka Masuda
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Congenital Agenesis ◽  
The Right

THE VALUE OF SERIAL CATECHOLAMINE DETERMINATIONS IN CHILDREN WITH NEUROBLASTOMA

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 241-246
Author(s):  
Mary L. Voorhess ◽  
Lytt I. Gardner
Keyword(s):  
Clinical Evidence ◽  
Recurrent Disease ◽  
Surgical Removal ◽  
Urinary Catecholamine ◽  
Urinary Catecholamines ◽  
Surgical Exploration ◽  
Catecholamine Excretion ◽  
Urinary Dopamine ◽  
The Right ◽  
Superior Pole

Urinary catecholamine excretion was measured in a 4-year-old child with neuroblastoma arising from the right adrenal. Initially urinary dopamine and norepinephrine output was high. Because the tumor was inoperable a course of radiation therapy and chemotherapy was given. Following this treatment catecholamine excretion decreased but never reached normal levels. Although there was no clinical evidence of persistent tumor, the elevated urinary output of dopamine and norepinephrine indicated residual neuroblastoma. Therefore surgical exploration was performed and tumor was found overlying the superior pole of the right kidney. After removal of this persistent neuroblastoma the urinary excretion of catecholamines returned to normal and remained at this level. The child has no evidence of recurrent disease and appears healthy. To our knowledge this represents the first reported case wherein the indication for surgical removal of residual neuroblastoma was based solely on elevated output of urinary catecholamines.

Abstract 14685: Efficacy of Combined Administration of Intracoronary Papaverine and Intravenous Adenosine 5’-Triphosphate in Assessment of Fractional Flow Reserve

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takeshi Nishi ◽  
Yoshihide Fujimoto ◽  
Yoshio Kobayashi
Keyword(s):  
Coronary Artery ◽  
Ventricular Arrhythmia ◽  
Fractional Flow Reserve ◽  
Left Coronary Artery ◽  
Shortness Of Breath ◽  
Fractional Flow ◽  
Ventricular Premature Contraction ◽  
Flow Reserve ◽  
Combined Administration ◽  
The Right

Purpose: Inducing maximal coronary hyperemia is important to measure fractional flow reserve (FFR) accurately. Administration of intracoronary (IC) papaverine and intravenous (IV) adenosine 5’-triphosphate (ATP) have been used to achieve maximal hyperemia in the assessment of FFR. However, they may not induce maximal hyperemia in all patients. We aimed to evaluate combined effect of IC papaverine and IV ATP on FFR measurements. Methods: FFR measurements using administration of IC papaverine (12 mg in the left coronary artery and 8 mg in the right coronary artery), IV ATP (140 μg/kg/min), and the combination of IC papaverine plus IV ATP (additional IC bolus infusion of papaverine during IV ATP) were performed in 57 lesions of 52 consecutive patients. FFR values, symptoms, development of atrioventricular block (AVB), and ventricular arrhythmia were recorded. Results: Mean FFR values with IC papaverine, IV ATP, and the combination of IC papaverine and IV ATP were comparable (0.75 ± 0.13 vs. 0.76 ± 0.13 vs. 0.75 ± 0.13, p = 0.87). The proportion of lesions with a positive FFR (FFR ≤0.80) were not significantly different between the 3 methods (54.4% vs. 47.4% vs. 64.9%, p = 0.17). IC papaverine and IV ATP detected 25 lesions and 32 lesions with a negative FFR (FFR > 0.80), respectively. Of these, 7 (28%) and 11 lesions (34%) showed positive FFR with the combination of IC papaverine and IV ATP. Within the region of physiologically intermediate FFR values (0.75 to 0.85 obtained by IV ATP), there were significant differences in the FFR values (0.81 ± 0.02 vs. 0.79 ± 0.03, p = 0.01) and the proportion of positive FFR (48.3% vs. 66.7%, p < 0.01) between IV ATP and the combination of IC papaverine and IV ATP. IC papaverine increased ventricular premature contraction in 2%. IV ATP caused flushing in 48%, chest oppression in 27%, shortness of breath in 10%, and transient 2nd degree AVB in 3%. The combination of IC papaverine and IV ATP caused transient 2nd degree AVB in 2%. Conclusions: The hyperemic efficacy of IC papaverine or IV ATP alone is suboptimal in some patients. Combined administration of IC papaverine and IV ATP can achieve optimal hyperemia in such patients and has the potential to assist in making clinical decisions on patients with physiologically intermediate lesions.

A case of primary malignant neoplasm in the lung

1901 ◽  
Vol 1 (10) ◽  
pp. 546-546
Author(s):  
F. K. Geisler
Keyword(s):  
Malignant Neoplasm ◽  
Shortness Of Breath ◽  
Left Half ◽  
Primary Malignant Neoplasm ◽  
General Weakness ◽  
Axillary Region ◽  
The Right ◽  
Respiratory Movements

Abstracts. Internal diseases.F.K. Geisler. A case of primary malignant neoplasm in the lung. Doctor. 1901 No. 23.Sick stove-maker, 43 y.o., potator. Ill 7 ms. The main seizures: cough, shortness of breath, feeling of pressure in the sternum and left half of the chest, increasing general weakness and hoarseness. Objective examination: depletion, enlargement of the cervical, genital and axillary glands; the left half of the chest is somewhat collapsed, the respiratory movements are weakened. Clear dullness from above to the left, from the front turning into cardiac dullness, to the right extending to the handle of the sternum; in the axillary region, the dullness reaches the 6th rib, and behind it occupies the suprascapular and scapular regions. On the right, the lung is emphysematous.

Rib fracture fixation in a patient on veno-venous ECMO for severe blunt thoracic trauma

2021 ◽  
Author(s):  
D Whittaker ◽  
C Edmunds ◽  
I Scott ◽  
M Khalil ◽  
I Stevenson
Keyword(s):  
Chest Wall ◽  
Fracture Fixation ◽  
Flail Chest ◽  
Ecmo Support ◽  
Rib Fracture ◽  
Respiratory Compromise ◽  
Respiratory Dysfunction ◽  
Rib Fixation ◽  
Chest Wall Trauma ◽  
The Right

Thoracic chest wall trauma is a common injury in patients admitted to hospital following injury and is associated with high mortality. British Orthopaedic Association Standards for Trauma and Orthopaedics guidelines recommend consideration of rib fracture fixation in patients with flail chest wall injuries with respiratory compromise or uncontrollable pain. Veno-venous extracorporeal membrane oxygenation (ECMO) can be utilised in patients with severe respiratory dysfunction and we present the case of a patient who underwent rib fracture fixation while receiving ECMO. A 32-year-old male was admitted to our department following a 4.5m fall. He sustained significant thoracic injuries with multiple ribs fractures and a flail segment from the right fourth to ninth ribs. Treatment consisted of bilateral chest drains, ECMO support, tracheostomy and rib fracture fixation to the eighth and ninth ribs. The patient made a rapid recovery following surgery and ECMO support was ceased 2.5 days postoperatively. The case shows that a well-prepared, combined specialty surgical team can safely perform rib fixation for a patient on ECMO.

Monophasic Synovial Sarcoma Arising in the Vulva: A Case Report and Review of the Literature

2008 ◽  
Vol 132 (4) ◽  
pp. 698-702
Author(s):  
Beverly E. White ◽  
Alan Kaplan ◽  
Dolores H. Lopez-Terrada ◽  
Jae Y. Ro ◽  
Robert S. Benjamin ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Soft Tissues ◽  
English Literature ◽  
Review Of The Literature ◽  
First Case ◽  
Additional Surgery ◽  
Synovial Sarcomas ◽  
The Right ◽  
Disease Free ◽  
Vulvar Mass

Abstract Synovial sarcomas most commonly arise in the soft tissue of the extremities. Less commonly, these tumors present in the head and neck, abdominal wall, and other sites. However, synovial sarcoma occurring in the vulvar area is extremely rare. Only 2 previous cases of biphasic synovial sarcoma of the vulva have been reported, but no case of vulvar monophasic synovial sarcoma has been described in the English literature. We report the third case of synovial sarcoma and apparently the first case of monophasic synovial sarcoma arising in soft tissues of the vulva. The patient was a 33-year-old woman who presented for evaluation of a painless vulvar mass. The tumor was located in the deep fibroadipose tissue of the right vulva (6.5 × 4.2 × 3.5 cm). The histology of the lesion was that of a monophasic synovial sarcoma with a hemangiopericytic vascular pattern. A subsequent molecular analysis revealed SYT-SSX2 gene fusion, which confirmed the diagnosis of synovial sarcoma. After an initial wide local excision, the patient developed a recurrence in the right groin and received chemotherapy and additional surgery. The patient is currently disease free, on adjuvant chemotherapy, and being followed up closely.

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