Complications of implantation of the cava filter "Réptéla"

The article describes a complication resulting from the implantation of a cava-filter for roentgen endovascular prophylactics of thromboembolism of the pulmonary artery (REPTEPA) to a 68 years old woman with recurring thromboembolism of the pulmonary artery, floating thrombus of the right iliac vein. An attempt to disconnect the cava-filter from the applicator after implantation proved to be unsuccessful which was followed by urgent operation: marginal resection of the vena cava inferior with the cava-filter, suture of the vein, cava plication. The nearest postoperative period was complicated by thrombosis of the plication zone. The examination in 6 months has shown the formation of the syndrome of the vena cava inferior.     

Parathyroid "double adenomas": fact of fiction?

It has been suggested that primary hyperparathyroidism (HPT) may occasionally be caused by "multiple adenomas." If this is true, then selective excision of the enlarged glands should be curative in such cases. To examine this proposition, we reviewed the records of 1,962 patients with surgically proved HPT and culled all those who met the following criteria: (1) identification and excision of two enlarged and histologically hypercellular parathyroid glands, each weighing more than 70 mg, and (2) identification and preservation of two other normal-sized parathyroid glands. There were 38 such patients (1.9% of the total group). Thirty-seven patients were euparathyroid at follow-up (an average of 4.6 years postoperatively). Only one individual, a member of a kindred with multiple endocrine neoplasia (MEN), type 1, had persistent HPT; but four other patients with MEN syndromes were among the group cured by surgery. The findings of this study support the notion that more than one adenoma may occasionally be found in primary HPT, and that selective excision of the enlarged glands with preservation of the normal parathyroid glands constitutes adequate treatment. One possible exception to this rule is the patient with either familial HPT or one of the MEN syndromes; subtotal parathyroidectomy is preferred in this situation.     

The effect of "Jingzhizhu" capsule on male fertility

Objective: To study the effect of "Jingzhizhu" capsule on male fertility, especially sperm density, motility and morphology. Methods: (1) Assess the semen quality of the 50 patients with oligospermia and/or asthenospermia after taking "Jingzhizhu" for one month; (2) Observe the fecundity, pathology and ultrastructure of testes and epididymes of mice after feeding "Jingzhizhu"; (3) Test the acute toxicity on mice. Results: "Jingzhizhu" capsule can significantly improve semen quality of the patients with oligospermia and/or asthenospermia, reverse the pathological change of testes and epididymes of mice. Toxicity test showed no toxic change. Conclusions: "Jingzhizhu" is safe and effective for male infertility.     

"Migration" of traumatic subarachnoid hematoma? A case report

BACKGROUND: Traumatic spinal SAH with neurologic deficits is rare and easily misdiagnosed, especially after traumatic intracranial hemorrhage. CASE DESCRIPTION: We report a case of spinal SAH with root compression occurring after a scooter accident. CONCLUSIONS: Physicians should be aware of descending migration of intracranial SAH as a possible cause of spinal cord or root compression, especially in the patient with late onset spinal symptoms.     

Is "zero-hour" biopsy of the transplanted kidney risky?

“Zero-hour” renal allograft biopsy provides valuable diagnostic information for comparison to subsequent kidney material. However, the invasive nature of the biopsy procedure tends to limit its widespread use in many centers. We undertook this retrospective study to examine the rate and clinical importance of complications in our series of patients routinely undergoing zero-hour biopsies performed between 1994 and 2001. Two hundred thirty-six zero-hour biopsies included only one sample performed with a 14G needle from lower posterior part of kidney by using a manual tru-cut technique. Doppler ultrasonography was performed after first 5 days. An average of 34 ± 19 glomeruli were obtained in the biopsies. The biopsy specimens were adequate for diagnosis in 77% of the procedures. Ten (4%) patients experienced complications of intraparenchymal arteriovenous fistula (n = 4), which regressed spontaneously; perirenal hematoma (n = 4); intraparenchymal hematoma (n = 2); and a minimal perirenal collection (n = 41). We conclude that zero-hour biopsy is a safe diagnostic method. The rate of complications is low, as well as generally mild and self-limiting.     

Seven years of cochlear implant at the ENT Clinic of "Recuperare" Hospital Iaşi

This paper presents our Cochlear Implant Departments results from the beginning until present time. Our implant list contains 161 candidates. The enlisted was made based on the criteria's for implant candidates' selection and we have implanted already 17 of them (11 children and 6 adults). Surgical interventions were done according to standard procedure - the approach being through mastoidectomy and posterior tympanotomy. We discuss the results obtained with cochlear implantation in each case. The outline idea is that the cochlear implant was a good choice in all our implanted cases and the patients had achieved at least the performances predicted before implantation for every particular situation.     

Does "clonal progression" relate to the development of intraductal papillary mucinous tumors of the pancreas?

Intraductal papillary mucinous tumors of the pancreas show a unique histologic feature in that the wide spectrum of intraductal epithelium is observed in the same pancreas. The aim of this study was to clarify whether or not the "clonal progression" relates to the development of this tumor. A total of 210 intraductal epithelium samples were microdissected from 23 resected specimens of intraductal papillary mucinous tumors of the pancreas, including nine carcinomas, five borderline tumors, and nine adenomas. After histologic grading (grades 1 to 4) of the individual epithelium, the K-ras point mutation and loss of heterozygosity in 9p21(p16) and 17p13(p53) were investigated. From the distribution of the K-ras point mutation of 210 microdissected specimens, an identical sequence of K-ras was demonstrated in the precursor lesions in most cases. K-ras mutation showed a single pattern, and the multiple or heterogeneous mutation pattern was not seen in this study. In the same ways, the distribution of loss of heterozygosity in 9p21(p16) and 17p13(p53) of 210 microdissected specimens was shown to be mostly clonal, without the presence of the genetic alterations. Such distributions of the identical genetic statuses in the precursor lesions are consistent with the presence of clonal progression during the development of this tumor. Presented at the Fifth World Congress of the International Hepato-Pancreato-Biliary Association, Tokyo, Japan, April 25–29, 2002, and at the Fourth Meeting of the American Hepato-Pancreato-Biliary Association, Miami, Florida, February 27–March 2, 2003. This study was partly supported by a Grant-in-Aid for Scientific Research of Japan Society for the Promotion of Science (no. 151790731).