Aagesenschulz1421
Foreign body (FB) aspiration in adults is usually associated with predisposing risk factors. Clinical manifestations are immediate but less frequently it could lead to insidious lung damage, as demonstrated by the presented case. We present a case of unsuspected FB aspiration, mimicking an infection vs lung tumour. After left lower lobectomy, pathology revealed a foreign body (animal bone) at the origin of the lingular bronchus.
Congenital chest wall deformities are common in children, causing self and parental concern mainly due to cosmesis. These defects rarely cause severe symptoms in patients.
11-year-old girl with a complex chest wall deformity and severe scoliosis causing progressive neurological loss of function. When mobilized to prone position for orthopedic surgery, she suffered sudden hypotension immediately followed by a cardiac arrest, that reverted after moving the child back to supine position. The cardiac arrest was interpreted as a result of a decrease in venous blood return secondary to heart and great vessels compression. She was then proposed and submitted to a modified Ravitch procedure with retrosternal metal bar placement in order to allow ventral positioning. This was successfully achieved, and the patient underwent scoliosis correction 3 months later. After more than a year of follow up, she reduced the need for non-invasive ventilation and tolerates prone positioning.
This case report alerts medical community that beyond cosmesis concerns, severe chest wall deformities can cause life-threatening events if not correctly managed.
This case report alerts medical community that beyond cosmesis concerns, severe chest wall deformities can cause life-threatening events if not correctly managed.Pancoast tumours are defined as tumours arising from the upper lobe and invading the thoracic inlet,representing less than 5% of all lung cancers. Clinical features depend on the involved structures. For many years invasion of the spine was considered unresectable and fatal. Due to the progress in spine surgery, en bloc resection including the spine is nowadays possible. We report the first case of a successful en bloc vertebral resection of a Pancoast tumour in a 66 year-old male, with a squamous cell carcinoma, treated at our department in a multidisciplinary setting, after induction chemoradiotherapy. An en bloc resection including the left upper lobe, the first three ribs and the vertebral body of D2, was performed through a Paulson incision after posterior cervico-dorsal arthrodesis. A complete R0 resection was confirmed on the pathology specimen. Currently, one year after surgery, although no local recurrence has occurred, the patient is being treated with immunotherapy due to disease progression in the right acetabulum which was irradiated (20Gy) and then submitted to iliac resection and prothesis reconstruction.Catheter directed thrombolysis is a minimally invasive procedure that results in a significant reduction in venous obstruction after deep vein thrombosis. The technique implies the performance of phlebographies to monitor the thrombolysis progression. The objective of this paper is to describe the use of vascular ultrasound to follow the thrombus lysis and to adjust the catheter position according to the progression of the thrombolysis. This is the first case reported describing the application of ultrasound to monitor the thrombolysis. A 36-year woman was admitted ilio-femoral vein. The ipsilateral great saphenous vein was the percutaneous access to perform the anterograde thrombolysis. The procedure, including the control of thrombus lysis, as well as catheter progression was performed under ultrasound guidance. The thrombolysis took 52 hours. The patient has two years of follow-up without any complaint. The use of vascular ultrasound to monitor the thrombolysis has several theoretical advantages in patients with adequate biotopes. It minimizes the number of venograms and can be performed at the bedside. It is effective and inexpensive.59-year-old women with permanent atrial fibrillation and previous haemorrhagic stroke was admitted for percutaneous left atrial appendage occlusion. Shortly after, AmplatzerTM device migration into the left ventricular outflow tract was confirmed. Unsuccessful transcatheter mobilization led to an emergent surgery for device retrieval and LAA closure. No events at 6-month follow-up.32 years-old female patient presented with lumbar pain. Computed tomography revealed varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein. This entity may pose technical difficulties during aortoiliac surgeries and renal surgeries as iatrogenic injury of this vessel may cause life- -threatening retroperitoneal hemorrhage.
The expression of epithelial progenitor cells (EPCs) in rat vagina was recently reported. The aims were to investigate the effects of estrogen on vaginal EPCs in the oophorectomized female rat model.
Female Sprague-Dawley rats (230-240 g, n=30) were divided into 3 groups control (n=10), bilateral oophorectomy (OVX, n=10), and bilateral OVX followed by subcutaneous injections of 17β-estradiol (50 μg/kg/day, n=10). After 4 weeks, the expression of EPC-specific markers (CD44, estrogen receptor alpha [ERα], and progesterone receptor) were evaluated by immunohistochemistry and Western blot.
The CD44/ERα double-labeled cells were mainly expressed in basal cell layers and suprabasal layers as shown by confocal immunofluorescence. LY3295668 solubility dmso Confocal microscopy revealed that the number of CD44+/ERα+ cells decreased in the OVX group compared with the controls but was similar to control levels in rats receiving estrogen replacements. The protein expression of CD44 and ERα decreased after OVX and was restored to control levels after estrogen supplementation.
Markers of EPCs were expressed in the vagina, and the expression of resident EPCs was regulated by estrogen. These findings imply that resident EPCs may have an important role in the regeneration of vaginal mucosa by estrogen replacement.
Markers of EPCs were expressed in the vagina, and the expression of resident EPCs was regulated by estrogen. These findings imply that resident EPCs may have an important role in the regeneration of vaginal mucosa by estrogen replacement.