A cutaneous hemangioma of the penis extending from the proximal portion of the glans to the prepuce of an 18-year-old man was successfully treated by sclerotherapy with polidocanol and interrupted ligation of the hemangioma.
Vascular Closure System clips were useful to coapt a prosthetic graft to an artery unless the arterial wall was thicker than 2 mm or calcified. Thus, VCS clips could be durable enough for graft-artery anastomoses in the iliac or popliteal region.
While duplex scanning has been advocated as the most accurate modality for postoperative graft surveillance, it is time-consuming for evaluating the entire graft. The aim of the present study was to determine which parameter predicts graft failure most simply and precisely, by examining 62 men and 1 woman who collectively underwent 71 infrainguinal arterial bypasses. A total of 212 scannings were obtained using a duplex scanner, and the peak systolic velocity (PSV), PSV ratio, and peak-to-peak pulsatility index (PPI) were analyzed. This analysis revealed 7 occlusions, 9 stenoses, and 1 arteriovenous fistula. When a PSV < 45 cm/s and/or a PSV ratio > 2.0 was defined as graft failure the sensitivity was 84.0% and the specificity was 81.8%: however, a PPI < 7.0 at the midgraft, indicating graft failure, showed a sensitivity of 100% and a specificity of 83.3%. The PPI exhibited better sensitivity and specificity than the PSV, even though the PPI needs only to be measured at the midgraft whereas the PSV should be measured at at least two points. Thus, we believe that the PPI could be the most useful and simple parameter to assess infrainguinal bypass grafts.
A 38-aged woman developed a moderate purpura and enanthema. Before 3 years when she had no bleeding tendency, she was diagnosed with retroperitoneal malignant lymphoma (follicular, large cell type) by a laparotomy and successfully treated with surgery and radiation. Laboratory tests at the time of the present admission revealed normal coagulation tests, platelet counts of 14-0,000/μl and prolonged bleeding time. Platelet aggregation by 1-10μM ADP showed a immediate lag time lasting 30-40 sec, then followed by an aggregation. Aggregation by epinephrine showed a loss of the first wave with a normal second wave. Collagen-induced aggregation showed an abnormally long lag time. Crossed immunoelectrophoresis (CIE) of \% Triton X-100 solubilized platelets from the patient revealed a two-peaked immunoprecipitate of GP IIb/IIIa complex, of which the abnormally slow peak was thought to be the GP IIb/IIIa complex coated with an antibody. CIE of her platelets also showed abnormally decreased amounts of both albumin and fibrinogen in the platelets, suggesting intravascular release reaction from her platelets stimulated with the antibody. She gradually developed EDTA-induced pseudo-thrombocytopenia with true platelet counts of 200,000-250,000/μl. Then, the patient developed true thrombocytopenia ranging from 9,000 to 37,000/μl and was found to have the left tonsillar swelling, which was subsequently diagnosed as a relapse of the malignant lymphoma by a biopsy and treated successfully by radiation. After the disappearance of the tumor, the patient's platelet counts increased to 160,000/μl. At this time, aggregation patterns by ADP, epinephrine or collagen were completely normalized. CIE of her platelets showed a normal shape of GP IIb/IIIa complex as well as normal amounts of albumin and fibrinogen. The purified IgG from the patient in the thrombocytopenic stage inhibited dose-dependently ADP- or epinephrine-induced aggregation of normal PRP. Western-blot analysis showed that the patient's IgG reacted with a protein of approx. 100kDa, corresponding to GP Ilia, in unreduced SDS-PAGE of normal platelets.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.