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Mild Stenosis (mild + stenosis)

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Medical Sciences	100%

Selected Abstracts

Prepuce-Sparing hypospadias repair with tubularized incised plate urethroplasty

INTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2008
Kenji Shimada
Objectives: Modifications in surgical methods of hypospadias repair have been influenced by social considerations. Most Japanese parents wish their children to retain their foreskin during hypospadias repair. We report on short-term results of foreskin reconstruction associated with hypospadias repair. Methods: Of 44 tubularized incised plate urethroplasty-patients, 42 (95%) underwent foreskin reconstruction at the time of urethroplasty during the last 2 years. After the urethroplasty was completed, the foreskin was re-approximated in three layers. Results: Complications related to urethroplasty consisted of fistula in two patients with penoscrotal hypospadia, and mild stenosis of the glandular urethra in one patient. Complications related to foreskin reconstruction included dehiscence of the ventral foreskin in two patients. In all cases parents were well satisfied with the reconstructed prepuce. Conclusions: Pre-operative information about preputial reconstruction should be given to parents if they would prefer their son to be uncircumcised. [source]

Comparison of Transcranial Color-Coded Sonography and Magnetic Resonance Angiography in Acute Ischemic Stroke

JOURNAL OF NEUROIMAGING, Issue 4 2001
Li-Ming Lien MD
ABSTRACT Background and Purpose. This study was designed to assess the accuracy of transcranial color-coded sonography (TCCS) as compared to magnetic resonance angiography (MRA) for detecting intracranial arterial stenosis in patients with acute cerebral ischemia. Methods. The authors prospectively identified 120 consecutive patients admitted with acute ischemic stroke and performed both TCCS and MRA with a mean interval of 1 day. TCCS data (sampling depth, peak systolic and end diastolic angle-corrected velocity, mean angle-corrected velocity, and pulsatility index) for middle cerebral arteries (MCAs) were compared to MRA data and classified into 4 grades: normal (grade 1): normal caliber and signal; mild stenosis (grade 2): irregular lumen with reduced signal; severe stenosis (grade 3): absent signal in the stenotic segment (flow gap) and reconstituted distal signal; and possible occlusion (grade 4): absent signal. The cutoffs were chosen to maximize diagnostic accuracy. Results. Interobserver agreement for MRA grading resulted in a weighted-kappa value of 0.776. The rate of poor temporal window was 37% (89/240). Doppler signals were obtained in 135 vessels, and the angle-corrected velocities (peak systolic, end diastolic, mean) were significantly different (P= .001, P= .006, P < .001) among the MRA grades: grade 1 (100, 47, 68 cm/s), grade 2 (171, 72, 110 cm/s), grade 3 (226, 79, 134 cm/s), grade 4 (61, 26, 39 cm/s). Additionally, an angle-corrected MCA peak systolic velocity ,120 cm/s correlates with intracranial stenosis on MRA (grade 2 or worse) with high specificity (90.5%; 95% confidence interval = 78.5%,96.8%) and positive predictive value (93.9%) but relatively low sensitivity (66.7%; 95% confidence interval = 61.2%,69.5%) and negative predictive value (55.1%). Conclusion. Elevated MCA velocities on TCCS correlate with intracranial stenosis detected on MRA. An angle-corrected peak systolic velocity ,120 cm/s is highly specific for detecting intracranial stenosis as defined by significant MRA abnormality. [source]

The effect of statin therapy on the progression of carotid artery stenosis in relation to stenosis severity

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010
O. Hegland
Objectives,,, To examine the effect of early statin treatment on progression of arteriosclerosis in internal carotid arteries (ICA); to compare the progression of arteriosclerosis in ICA of patients treated with a statin to the progression seen in drug-naïve patients. Patients and methods,,, We performed repetitive Doppler scans of 363 carotid arteries with ICA stenosis ,40% in 254 patients over time. Information on statin therapy and other risk factors for stroke were correlated with the annual change in degree of ICA stenosis. Results,,, In statin-treated patients, 19% of ICA stenosis showed a progression while 74% showed a regression of stenosis. In statin - naïve patients, 63% of stenotic arteries showed a progression, while a reduction could be observed in 28%. Decrease of ICA stenosis was most accentuated in patients with a mild stenosis and was independent of serum cholesterol levels. Conclusion,,, Treatment with statins already in early stages of ICA stenosis might delay the progression and even reverse the degree of stenosis. [source]

Magnetic Resonance Imaging of Carcinoid Heart Disease

CLINICAL CARDIOLOGY, Issue 6 2009
Damian Franzen
In a 56-year-old lady, a carcinoid tumor of the terminal ileum metastasized to regional lymph nodes, and the liver was removed by hemicolectomy in 2002. Following a history of cutaneous flushing, diarrhea, and bronchoconstriction 3 years later, a somatostatin therapy was instituted. As flushing and diarrhea resolved and levels of urinary excretion of 5-hydoxyindoleacetic acid decreased, shortness of breath was progressive and prompted a cardiac exam. Despite poor resolution, echocardiography revealed a thickening of the tricuspid valves (TK) with reduced mobility along with right atrial (RA) and right ventricular (RV) dilatation. The pulmonary valve was unobtrusive. Magnetic resonance (MR) imaging revealed extensive fibrous tissue extending from the valvular base to the tip of the tricuspid leaflets. Retraction and immobilization of the TK caused a mild stenosis and a large regurgitant flow. Because medical treatment of tricuspid regurgitation was ineffective, the TK was excised and a Hancock 25-mm bioprosthetic valve was implanted. The postoperative course was uncomplicated, and the patient recuperated and resumed normal daily activities. Copyright © 2009 Wiley Periodicals, Inc. [source]