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Catheter Cardiovasc Interv. 2002 Dec;57(4):504-7.
Suture-mediated closure of antegrade femoral arteriotomy following infrainguinal intervention.
Khosla S, Kunjummen B, Guerrero M, Manda R, Razminia M, Ahmed A.
Section of Cardiology and Endovascular Therapeutics, Mount Sinai Hospital, Chicago, Illinois 60608, USA. khoinai.org
Antegrade femoral arterial access has been less commonly adopted for infrainguinal intervention due to increased risk of retroperitoneal hemorrhage secondary to noncompressibility of arteriotomy site. We evaluated the efficacy and safety of suture-mediated closure of antegrade femoral arteriotomy using the Closer device. Twelve consecutive patients undergoing infrainguinal intervention (females, 5; mean body weight, 69 +/- 16 kg; limb threatening ischemia, 50%) underwent repair of the antegrade femoral arteriotomy immediately postprocedure using the Closer. Indications for antegrade access were excessive iliac tortuosity (6/12), long femoral artery occlusion (5/12), and bilateral aortoiliac bifurcation stents (1/12). The acute procedural success (immediate hemostasis without need for manual compression) was 100%. The mean time to ambulation was 3.9 +/- 1.5 hr and the procedure-related length of stay was 18 +/- 5.5 hr. In conclusion, repair of antegrade arterial puncture is safe and effective following infrainguinal intervention. 2002 Wiley-Liss, Inc.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12455086&dopt=Abstract hemorrhage
Arch Esp Urol. 2002 Oct;55(8):955-8.
[Spontaneous retroperitoneal hemorrhage caused by a pheochromocytoma]
[Article in Spanish]
Garcia Rodriguez J, Fernandez Gomez JM, Rodriguez Martinez JJ, Rodriguez Faba O, Regadera Sejas J, Escaf Barmadah S.
Servicio de Urologia I, Hospital Central de Asturias, Oviedo, Asturias, Espana.
OBJECTIVE: To report the case of an adrenal pheochromocytoma presenting as a retroperitoneal haemorrhage. METHODS: 53 year old patient without previous medical history who presents with a spontaneous retroperitoneal haemorrhage. RESULTS: CT-scan was performed showing a retroperitoneal collection. The patient underwent emergency adrenalectomy with a final histopathologic diagnosis of pheochromocytoma. CONCLUSION: Pheochromocytomas can occasionally present as Wunderlich's syndrome, needing radical surgery as treatment for its resolution.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12455289&dopt=Abstract hemorrhage
Rev Esp Anestesiol Reanim. 2002 Oct;49(8):432-4.
[In Process Citation]
[Article in Spanish]
Rodriguez MA, Perez JA, Cutillas MJ, Cantos E, Padilla J, Cura S.
Servicio de Anestesiologia y Reanimacion, Hospital General Universitario JM Morales Meseguer de Murcia, Murcia. marodrigueznavarrahoo.es
Injury to a large-caliber artery transurethral resection of a bladder tumor is a rare but serious complication. It is important that an anesthesiologist be able to detect such an injury, in order to include it among the many differential etiological diagnoses for shock. A 75-years-old man reported hematuria. An ultrasound image of the bladder showed many neoformations consistent with a diagnosis of multiple bladder neoplasms, and transurethral endoscopy was performed under subarachnoid anesthesia. Acute hypotension, bradycardia and shock developed 30 minutes into the procedure. The diagnosis was hypovolemic shock due to acute intraoperative hemorrhage, and exploratory laparotomy revealed an opening in the common iliac artery. The rupture was sutured. In spite of administration of crystalloids, colloids, blood products and vasoactive agents, a second operation was required due to hemodynamic instability. The patient died in the intensive care unit.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12455325&dopt=Abstract hemorrhage [PubMed - in process]
Am Surg. 2002 Nov;68(11):1026-8.
Benign anatomical mistakes: incidentaloma.
Mirilas P, Skandalakis JE.
Centers for Surgical Anatomy and Technique, Emory University, Atlanta, Georgia 30322, USA.
The concept of the "incidentaloma," a totally asymptomatic nonfunctional tumor that is clinically and biochemically silent and discovered "incidentally" in a totally asymptomatic patient, is a by-product of the evolving diagnostic techniques of the last three decades. Various authors have used the concept for "incidental" findings during diagnostic workup for symptoms unrelated to adrenal disease, or for "incidental" adrenal tumors unrelated to symptoms that could potentially be of adrenal origin. "Incidentaloma" has been used to encompass a wide and heterogeneous spectrum of pathologic entities including adrenocortical and medullary tumors, benign or malignant lesions, hormonally active or inactive lesions, metastases, infections, granulomas, infiltrations, cysts and pseudocysts, hemorrhages, and pseudoadrenal masses. The term "incidentaloma" does not indicate whether the mass is functional, or malignant, or adrenocortical in origin. "Incidentaloma" has also appeared in the literature in reference to other endocrine organs such as pituitary, thyroid, and parathyroids, as well as the liver or kidney. We question the scientific justification for this neologism and suggest that it should be abolished. Questionable lesions should be clearly and simply described as "incidentally found."
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12455801&dopt=Abstract hemorrhage
Contemp Top Lab Anim Sci. 1998 Mar;37(2):75-77.
Ganglioneuroma in the Adrenal Gland of a Rat.
Goelz M, Dixon D, Myers P, Clark J, Forsythe D.
Comparative Medicine Branch, The National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709.
Necropsy was performed on a 22-month-old male Fischer 344 rat (Rattus norvegicus) that had weight loss and was icteric. Examination revealed a large, smooth, circumscribed, tan mass located at the cranial border of the right kidney. Microscopically, the mass consisted almost entirely of well-differentiated ganglion cells mixed with satellite and Schwann cells within a neurofibrillar matrix. The cells displaced the adrenal medulla and were partially surrounded by a thin rim of compressed adrenal cortex. Focal areas of hemorrhage and infiltrates of leukemic mononuclear cells were evident throughout the mass, but pheochromocytes were not detected. On the basis of findings during histologic examination, a diagnosis of adrenal medullary ganglioneuroma was made. Mononuclear cell leukemia was also diagnosed in the adrenal gland and was evident in lymphoid organs such as the spleen and mesenteric lymph nodes. Ganglioneuroma is rarely seen in rats and can be differentiated from more common complex pheochromocytomas, which consist of fewer neural components (< 80% of the mass). In rats, ganglioneuromas can develop in the central nervous system, pituitary gland, and thyroid gland. Differential diagnoses for a primary neoplasm of the adrenal gland should include carcinomas and adenomas of the adrenal cortex, and pheochromocytomas, neuroblastomas, and ganglioneuromas of the adrenal medulla.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12456176&dopt=Abstract hemorrhage [PubMed - as supplied by publisher]
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DHEA is a natural hormone, and it is produced in our body by the adrenal glands.
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